Peter Wibisono, PT | |
5601 De Soto Ave, Woodland Hills, CA 91367-6701 | |
(818) 719-2773 | |
Not Available |
Full Name | Peter Wibisono |
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Gender | Male |
Speciality | Physical Therapist |
Location | 5601 De Soto Ave, Woodland Hills, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366654469 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 26160 (California) | Primary |
Provider Name | Southern California Permanente Medical Group |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
Mailing Address | Practice Location Address |
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Peter Wibisono, PT 1526 N Edgemont St, Los Angeles, CA 90027-5260 Ph: (323) 783-8070 | Peter Wibisono, PT 5601 De Soto Ave, Woodland Hills, CA 91367-6701 Ph: (818) 719-2773 |
Timothy Starr, MPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 5601 De Soto Ave, Physical Therapy Department, Woodland Hills, CA 91367 Phone: 818-719-2930 | |
Leena Uranwala, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 23388 Mulholland Dr, Saban Center, Woodland Hills, CA 91364 Phone: 818-876-1006 Fax: 818-876-0542 | |
Lan Phuong Boehme, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 23388 Mulholland Dr, Mail Stop 22, Woodland Hills, CA 91364 Phone: 818-876-1006 Fax: 818-876-0542 | |
Dorothy M Machado, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5601 De Soto Ave, Woodland Hills, CA 91367 Phone: 818-719-4538 | |
Jaclyn Chan, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 20501 Ventura Blvd Ste 380, Woodland Hills, CA 91364 Phone: 818-343-3900 | |
Ms. Iwona Piekos, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5080 San Feliciano Dr, Woodland Hills, CA 91364 Phone: 805-358-3392 Fax: 818-592-0673 | |
Andrey Gokhgauzer, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 21051 Warner Center Ln Ste 100, Woodland Hills, CA 91367 Phone: 424-335-5505 |