Immanuel Aditya Tjahjadi

Primary specialty

PharmacistTaxonomy code 183500000X

License

91180 Issued in CA

Practice address

533 Parnassus Ave
San Francisco, CA 94143-2208

Phone

(626) 715-4062

NPI assigned

Sep 16, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1295646263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 N AZUSA AVE APT 8",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911077",
            "telephone_number": "626-715-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432208",
            "telephone_number": "626-715-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TJAHJADI",
        "first_name": "IMMANUEL",
        "middle_name": "ADITYA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "91180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisa Title
• Robin Louise Tittle, MD
• Erron Wilcox Titus, MD, PHD
• Ryan Alyson-Yao Tiu
• Andrea Beth Tivers
• Nathasa Tjahjadi
• Tina Tjahjadi
• Katherine Tjhin-Keophiphat
• Hermanus Tjiong, L.AC.
• Willy Tjong

• Pharmacist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.