Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jeffrey Wonoprabowo, MD

Individual provider Internal Medicine Physician · NPI 1629330436

Dr. Jeffrey Wonoprabowo, MD is a Hospitalist in Loma Linda, California. Graduated from Loma Linda University School of Medicine in 2012, 14 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
14
Trained at
Loma Linda University School of Medicine
Licensed in
CA
In the registry since
2012
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

11234 Anderson St Gme Ofc Csp 21005
Loma Linda, CA 92350-1716
Phone: (909) 558-7263
Fax: (909) 558-0427
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence A126969 (CA)

Record details

NPI number1629330436
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 8, 2012
Last updated in NPPESOctober 25, 2024
Certification dateJuly 30, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyHOSPITALIST
Also practisesINTERNAL MEDICINE
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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