Imansjah, Audreyandra Lucia

Imansjah, Audreyandra Lucia is an sole proprietor health care provider with primary practice located at 2300 Camino Ramon , San Ramon CA 94583-1354. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Imansjah, Audreyandra Lucia can be contacted via phone (925) 244-7400.

Contact Information

Primary practice address
2300 Camino Ramon San Ramon CA 94583-1354
Phone: (925) 244-7400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 17597 California

Profile Details

NPI number 1710481858
LBN Legal business name Imansjah, Audreyandra Lucia
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 22nd, 2018
Last updated Apr 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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