Healthcare Provider Details

I. General information

NPI: 1386608230
Provider Name (Legal Business Name): ROBERT HENRY WINOKUR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2006
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27700 MEDICAL CENTER RD
MISSION VIEJO CA
92691-6426
US

IV. Provider business mailing address

14 S PEAK
LAGUNA NIGUEL CA
92677-2903
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-1400
  • Fax: 949-248-9990
Mailing address:
  • Phone: 949-235-5110
  • Fax: 949-248-9990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG048741
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: