Healthcare Provider Details

I. General information

NPI: 1144470337
Provider Name (Legal Business Name): GREG WINTER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

3081 CLAIREMONT DR
SAN DIEGO CA
92117
US

IV. Provider business mailing address

3247 NORZEL DR
SAN DIEGO CA
92111-4640
US

V. Phone/Fax

Practice location:
  • Phone: 619-275-1175
  • Fax: 619-275-6764
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number51858
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: