Conny Tirtaman-Sie, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C52357 Issued in CA

Practice address

11201 Benton St
Loma Linda, CA 92357-1000

Phone

(909) 825-7084

Fax

(909) 583-6726

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other names 1

• Dr. Conny Tirtaman Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1043306947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1576",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541576",
            "telephone_number": "909-825-7084",
            "fax_number": "909-583-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571000",
            "telephone_number": "909-825-7084",
            "fax_number": "909-583-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRTAMAN-SIE",
        "first_name": "CONNY",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00040886",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0083971",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C52357",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C52357",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNY",
            "last_name": "TIRTAMAN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Timothy, NP
• Tristan S Tims
• Cynthia H Tinsley, M.D.
• Khin M Tint
• Abhishek Tippabhatla
• Candice Yolanda Tizcareno
• Billy Nugrawan Tjitrajadi, PHARMD
• Laura Tobing, MD
• Stanley Lumban Tobing, FNP
• Tarrah Tokishi, NP

• Internal Medicine Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.