Individual provider · Type 1 NPI
Sungguh Manullang
Family Nurse Practitioner · Loma Linda, CA
NPI number
1740115856
Active
Practice location
11234 Anderson St
Loma Linda, CA 92350-1716
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 95039627 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1740115856
Sungguh Manullang's National Provider Identifier is 1740115856, issued on Jun 17, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Loma Linda, CA. The record was last updated on Jun 17, 2026.