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1700124161
BERNARDUS GANI SUGIARTO KARTONO WINARDI
LOMPOC, CA
NPI
1700124161
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208000000X Pediatrics
(Licence: CA A135298)
Additional Taxonomies
282N00000X General Acute Care Hospital
Enumeration Date
2013-01-19
Last Update Date
2016-11-21
Business Address
-- BERNARDUS GANI SUGIARTO KARTONO WINARDI MD
425 W CENTRAL AVE SUITE 201
LOMPOC, CA 93436-2805
Phone number: 805-737-1169
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Mailing Address
-- BERNARDUS GANI SUGIARTO KARTONO WINARDI MD
2050 S BLOSSER RD
SANTA MARIA, CA 93458-7310
Phone number: 805-361-8028
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