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

Melissa Wibowo, MD

Individual provider Family Medicine Physician · NPI 1336728658

Melissa Wibowo, MD is a Family Practice in Santa Clara, California. Graduated from Wake Forest University School of Medicine in 2021, 5 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
5
Trained at
Wake Forest University School of Medicine
Licensed in
CA
In the registry since
2021
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

710 Lawrence Expy
Santa Clara, CA 95051-5173
Phone: (408) 851-4163
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A183198 (CA)

Record details

NPI number1336728658
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 5, 2021
Last updated in NPPESAugust 22, 2024
Certification dateAugust 22, 2024
Mailing address710 Lawrence Expy, Santa Clara, CA 95051-5173

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolWAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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