Healthcare Provider Details

I. General information

NPI: 1265456636
Provider Name (Legal Business Name): HEIDI WINKLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 10/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 ORR AND DAY RD STE A
SANTA FE SPRINGS CA
90670-3581
US

IV. Provider business mailing address

PO BOX 1496
LOS ALAMITOS CA
90720-1496
US

V. Phone/Fax

Practice location:
  • Phone: 562-864-4000
  • Fax: 562-864-4001
Mailing address:
  • Phone: 562-760-9559
  • Fax: 562-864-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA50311
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: