Stefanus Muljana MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A39505 Issued in CA

Legal business name

STEFANUS MULJANA MD INC

Practice address

724 N Garey Ave
Pomona, CA 91767-4614

Phone

(909) 865-6255

Fax

(909) 865-6355

NPI assigned

Apr 25, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Stefanus Muljana, MD

Title

President

Phone

(909) 865-6255

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1083972285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917674614",
            "telephone_number": "909-865-6255",
            "fax_number": "909-865-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917674614",
            "telephone_number": "909-865-6255",
            "fax_number": "909-865-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEFANUS MULJANA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "MULJANA",
        "authorized_official_first_name": "STEFANUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-865-6255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A39505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A395051",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A39505B",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Cole Stauffer
• Adam Stawniczy, PA-C
• Christopher Robert Steckling, M.D.
• Jeffrey Bernard Steed II, PA-C
• Jordan Steelquist
• Christy Lee Steider
• Dana Stein
• David Stein
• Lisa Stein
• Jaycee Amanda Steinmetz

• Internal Medicine Physician in Pomona, CA
• Providers in Pomona, 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 Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.