| Kencana Healthcare Inc | |
|
9525 Monte Vista Ave Unit 105 Montclair CA 91763-2208 | |
| (909) 626-1205 | |
| Not Available |
| Full Name | Kencana Healthcare Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9525 Monte Vista Ave Unit 105, Montclair, California |
| Authorized Official Name and Position | Dion Adiputra Kencana (CEO) |
| Authorized Official Contact | 7145803071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kencana Healthcare Inc 217 N Lincoln Ave Apt A Monterey Park CA 91755-1729 Ph: (714) 580-3071 | Kencana Healthcare Inc 9525 Monte Vista Ave Unit 105 Montclair CA 91763-2208 Ph: (909) 626-1205 |
| NPI Number | 1811784564 |
|---|---|
| Provider Enumeration Date | 04/24/2025 |
| Last Update Date | 07/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811784564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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