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NPI Code Detail

MEDICARE: PHOEBE ANN WINN MD

MEDICARE: PHOEBE ANN WINN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1821559956
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHOEBE ANN WINN MD
Provider Business Mailing Address
First Line : 322 LAWTON ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94122-3601
Country : US
Telephone Number : 415-830-2908
Fax Number :
Provider Business Practice Location Address
First Line : 747 52ND ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-1809
Country : US
Telephone Number : 510-428-3331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2019
Last Update Date : 03/29/2019

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