Search › Nevada › 2083X0100X
Yudi Wibisono, DO
NPI 1740711134 · on the registry since 2017
Practice
- Address
- 6900 N Pecos Rd
North Las Vegas, NV 89086 - Phone
- (702) 791-9000
- Organisation at this address
- Las Vegas Vamc
Las Vegas Vamc
Va Of Southern Nv
Southern Nevada Va Medical CenterInferred from a shared address, not stated in the registry. - Clinicians at this address
- 682
Additional practice sites
- 391 S Chipeta Way Ste C, Salt Lake City, UT
- 1400 Pottery Ave, Port Orchard, WA
Registry record
- Primary taxonomy
- 2083X0100X
2083X0100X
- Also registered as
- 207R00000X
2083P0500X
2083X0100X - Licence states on file
- ID, UT, WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-10-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Nevada