Healthcare Provider Details

I. General information

NPI: 1992923460
Provider Name (Legal Business Name): PETER JOHN WINKLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11741 VALLEY VIEW ST A
CYPRESS CA
90630-5500
US

IV. Provider business mailing address

11741 VALLEY VIEW ST A
CYPRESS CA
90630-5500
US

V. Phone/Fax

Practice location:
  • Phone: 714-897-1071
  • Fax: 714-897-0125
Mailing address:
  • Phone: 714-897-1071
  • Fax: 714-897-0125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG70077
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG70077
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: