Healthcare Provider Details

I. General information

NPI: 1811147903
Provider Name (Legal Business Name): REX J. WINTERS,MD ;INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ATLANTIC AVE
LONG BEACH CA
90806-1701
US

IV. Provider business mailing address

2898 LINDEN AVE
LONG BEACH CA
90806-1627
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-2000
  • Fax:
Mailing address:
  • Phone: 562-595-8671
  • Fax: 562-989-0999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG65833
License Number StateCA

VIII. Authorized Official

Name: DR. REX JAY WINTERS
Title or Position: OWNER/PRESIDANT
Credential: MD
Phone: 562-595-8671