Wardono, Ira Paula

Wardono, Ira Paula is an individual health care provider with primary practice located at 18321 Clark St , Tarzana CA 91356-3501. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wardono, Ira Paula can be contacted via phone (818) 881-0800.

Contact Information

Primary practice address
18321 Clark St Tarzana CA 91356-3501
Phone: (818) 881-0800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD431846 Pennsylvania
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A112875 California

Profile Details

NPI number 1134324148
LBN Legal business name Wardono, Ira Paula
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2007
Last updated Jul 1st, 2020 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1134324148 NPPES
Pennsylvania MEDICAID 1020378080001
Pennsylvania Other 001993563
Pennsylvania Other 824184

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