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General NPI Number Information
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NPI Number | 1285637652
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Entity Type | Individual
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Provider Name | JEFFREY P WINICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 1165 DALLAS RD
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City | FALLBROOK
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State | CA
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Zip | 92028-3680
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Country | US
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Telephone | 559-573-2845
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Fax |
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Provider Business Mailing Address
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Address Line | 1165 DALLAS RD
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City | FALLBROOK
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State | CA
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Zip | 92028-3680
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Country | US
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Telephone | 559-573-2845
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G46812
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 50258-020
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036120884
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 2008014399
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License Number State | MO
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