DR. MUDJIANTO CHANDRA (NPI# 1225152515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225152515 |
| Entity Type | Individual |
| Full Name | DR. MUDJIANTO CHANDRA |
| Credential | M.D. |
| Practice Address |
18370 Burbank Blvd Suite 607 Tarzana CA 91356-2804 |
| Practice Telephone | 8187098161 |
| Practice Fax Number | 8187098160 |
| Mailing Telephone | 8187098161 |
| Mailing Fax Number | 8187098160 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 208600000X | Surgery | A52198 | CA | Allopathic & Osteopathic Physicians |
| X | 208C00000X | Colon & Rectal Surgery | A52198 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | 00A521980 | 01 |
| CA | 00A521980 | 05 | |
| CA | BLUE CROSS | A52198 | 01 |
| OXFORD | P92709600 | 01 | |
| OTHER | A52198 | 01 | |
| TRICARE | A52198 | 01 |
| Street Address |
18370 BURBANK BLVD SUITE 607 |
| City | TARZANA |
| State | CA |
| Zip Code | 91356-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487658811 | Ardeshir Soroushyari | Internal Medicine | 18370 Burbank Blvd, Ste 601, Tarzana, CA 91356-2831 | 2005-06-13 |
| 1700437241 | Michelle Roxas Tran | Nurse Practitioner | 18370 Burbank Blvd, Tarzana, CA 91356-2804 | 2019-09-26 |
| 1063886166 | Comprehensive Infectious Disease Consultants A Medical Corporation | Internal Medicine | 18370 Burbank Blvd, Ste 414, Tarzana, CA 91356-2804 | 2015-11-30 |
| 1700268372 | Tarzana Surgery Center, Inc. | Clinic/Center | 18370 Burbank Blvd, #100, Tarzana, CA 91356-2804 | 2015-06-19 |
| 1013300631 | Nicholas Michael Panagiotis, Md Inc | Specialist | 18370 Burbank Blvd, 507, Tarzana, CA 91356-2804 | 2015-03-05 |
| 1942698840 | Atif Alaziz M.d. Inc | Clinic/Center | 18370 Burbank Blvd, Suite 201, Tarzana, CA 91356-2804 | 2014-12-30 |
| 1720412281 | S S Medical Associates Inc | Ophthalmology | 18370 Burbank Blvd, Suite 207, Tarzana, CA 91356-2804 | 2013-09-02 |
| 1215272059 | Kamyar Kamjoo Md A Medical Corporation | Internal Medicine | 18370 Burbank Blvd, Suite 714, Tarzana, CA 91356-2804 | 2012-12-05 |
| 1811240989 | Shelley Susman, M.d., Inc. | Obstetrics & Gynecology | 18370 Burbank Blvd, Suite 100, Tarzana, CA 91356-2804 | 2012-10-26 |
| 1952675373 | Daryl P. Alexander, Md Apc | Obstetrics & Gynecology | 18370 Burbank Blvd, 100, Tarzana, CA 91356-2804 | 2012-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679137293 | Sarah Badreau | Behavior Technician | 5554 Reseda Blv., Tarzana, CA 91356 | 2019-04-29 |
| 1831661966 | Daraie Dental Group Inc | Dentist | 5620 Wilbur Avenue Ste 300, Tarzana, CA 91356 | 2018-12-31 |
| 1982182770 | Blanca Garay | Respiratory Therapist, Registered | 18214 Burbank Blvd Apt 120, Tarzana, CA 91356 | 2018-08-02 |
| 1437659000 | Chloe Kang | Speech-Language Pathologist | 19019 Ventura Blvd., Tarzana, CA 91356 | 2018-02-20 |
| 1114430139 | Avb & Lv Corporation | Home Health | 18340 Ventura Blvd Ste 220, Tarzana, CA 91356 | 2017-11-13 |
| 1881110468 | Samina Qadir | Registered Nurse | 18321 Clark St., Tarzana, CA 91356 | 2017-08-16 |
| 1700306776 | Debbie Rehman Lux | Marriage & Family Therapist | 18370 Burbank Blvd., Suite 211, Tarzana, CA 91356 | 2017-06-21 |
| 1467980631 | Valley Nerological Services, LLC | Radiology | 5260 Wilbur Ave Ste 207, Tarzana, CA 91356 | 2017-05-31 |
| 1669906020 | Evolve Growth Initiatives LLC | Clinic/Center | 5435 Aura Avenue, Tarzana, CA 91356 | 2017-04-12 |
| 1780130088 | Evolve Growth Initiatives, LLC | Clinic/Center | 5358 Vanalden Drive, Tarzana, CA 91356 | 2016-08-28 |
| Find all providers in zip 91356 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447591599 | Peteris Bormanis | Surgery | 4933 Matula Dr, Tarzana, CA 91356-4005 | 2013-03-13 |
| 1477899615 | Douglas J Morrow Md Inc | Surgery | 18370 Burbank Blvd #607, Tarzana, CA 91356 | 2012-12-17 |
| 1427562677 | La Weight Loss | Surgery | 18425 Burbank Blvd Ste 102, Tarzana, CA 91356-2812 | 2017-11-27 |
| 1376779363 | Tarzana Surgical Specialists Inc | Surgery | 18425 Burbank Blvd, Suite 105, Tarzana, CA 91356-2806 | 2009-06-03 |
| 1457540502 | Raymond Rivera | Surgery | 5525 Etiwanda Ave, Suite 222, Tarzana, CA 91356-3647 | 2007-10-15 |
| 1528284726 | Raymond T. Rivera, Md Apc | Surgery | 5525 Etiwanda Ave, Suite 222, Tarzana, CA 91356-3647 | 2007-04-17 |
| 1457476780 | David Sievers | Surgery | 18370 Burbank Blvd, Suite 607, Tarzana, CA 91356-2804 | 2007-03-19 |
| 1992853477 | Lana D Louie | Surgery | 18370 Burbank Blvd, Suite 607, Tarzana, CA 91356-2804 | 2007-01-08 |
| 1780772582 | Krikor B. Tatoyan, M.d., Inc. | Surgery | 18425 Burbank Blvd, Ste. 105, Tarzana, CA 91356-2806 | 2006-10-10 |
| 1881605848 | Allen L Hoffman | Surgery | 18411 Clark St, Suite 305, Tarzana, CA 91356-3506 | 2006-08-11 |
| Find all providers in TARZANA | ||||
Please comment or provide details below to improve the information on DR. MUDJIANTO CHANDRA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.