Mudjianto Chandra, M.D., Inc.
NPI 1083658827ActiveOrganization· Colon & Rectal Surgery· Tarzana, CA
Colon & Rectal Surgery in Tarzana, California, registered in NPPES in June 2006. The authorized official on file is Mudjianto Chandra, M.D., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1083658827 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 15, 2006 |
| Last updated in NPPES | Sep 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Colon & Rectal Surgery Primary | 208C00000X | A52198 | CA |
| Surgery | 208600000X | A52198 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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