IMAWATI BUDIHARDJO M.D., PH.D
NPI 1043337173
Internal Medicine - Hematology & Oncology in La Jolla, CA

Q: What is Imawati Budihardjo's NPI number?

The NPI number for Imawati Budihardjo is 1043337173. It was assigned to this individual provider in the NPPES registry on March 23, 2007.

Q: What is Imawati Budihardjo's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Active since March 23, 2007

3855 HEALTH SCIENCES DR # 0658, LA JOLLA, CA 92093(858) 822-6100(858) 822-6186 Get Directions Write a Review

NPPES record last updated: October 12, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Imawati Budihardjo M.d., Ph.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMAWATI BUDIHARDJO M.D., PH.D (NPI 1043337173) is an individual hematology & oncology provider in La Jolla, California, licensed in California (A84421) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1043337173

Entity TypeIndividualFemale

Primary Taxonomy207RH0003X

Provider Legal NameIMAWATI BUDIHARDJOCredential: M.D., PH.D

Location Address3855 HEALTH SCIENCES DR # 0658La Jolla, CA 92093-0987

Mailing Address3855 Health Sciences Drive, Room 2016La Jolla, CA 92093-0698 · (858) 822-7916 · Fax (858) 822-5380

Phone(858) 822-6100

Fax(858) 822-6186

Sole ProprietorYes

Enumeration DateMarch 23, 2007

Last NPPES UpdateOctober 12, 2007

✔ NPI 1043337173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in CA · A84421

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

3855 HEALTH SCIENCES DR # 0658, La Jolla, CA 92093

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Imawati Budihardjo's NPI number?

The NPI number for Imawati Budihardjo is 1043337173. It was assigned to this individual provider in the NPPES registry on March 23, 2007.

Where is Imawati Budihardjo located?

Imawati Budihardjo practices at 3855 Health Sciences Dr # 0658, La Jolla, CA 92093. The listed phone number is (858) 822-6100.

What is Imawati Budihardjo's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

When was this NPI record last updated?

The NPPES record for Imawati Budihardjo was last updated on October 12, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.