Healthcare Provider Details

I. General information

NPI: 1689888190
Provider Name (Legal Business Name): ROBERT D WINKLER PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
STANFORD CA
94305-2200
US

IV. Provider business mailing address

445 GIANNINI DR
SANTA CLARA CA
95051-5851
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-6701
  • Fax:
Mailing address:
  • Phone: 408-247-7680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberAT 1809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: