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1578177630
WILBERT TIRTADINATA
OAKLAND, CA
NPI
1578177630
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: CA 95002000)
Enumeration Date
2020-09-04
Last Update Date
2024-03-13
Business Address
WILBERT TIRTADINATA
3600 BROADWAY
OAKLAND, CA 94611-5730
Phone number: 510-752-1000
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Mailing Address
WILBERT TIRTADINATA
3600 BROADWAY
OAKLAND, CA 94611-5730
Phone number: 510-752-1000
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