JONATHAN WIBISONO

BEAUMONT, CA
NPI1992158653
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: CA  95004343)
Enumeration Date2016-07-18
Last Update Date2016-07-18
Business Address
-- JONATHAN WIBISONO NP
851 E 6TH ST SUITE B-4
BEAUMONT, CA 92223-2340
Phone number: 951-845-2294
Mailing Address
-- JONATHAN WIBISONO NP
851 E 6TH ST SUITE B-4
BEAUMONT, CA 92223-2340
Phone number: 951-845-2294
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