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General NPI Number Information
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NPI Number | 1588843486
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Entity Type | Organization
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Legal Business Name | WILLIAM W WINTERNITZ JR MD INC
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 12630 MONTE VISTA RD STE 105
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City | POWAY
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State | CA
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Zip | 92064-2526
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Country | US
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Telephone | 858-487-6440
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Fax | 858-487-7281
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Provider Business Mailing Address
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Address Line | 2330 CAMBRIDGE AVE
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City | CARDIFF
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State | CA
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Zip | 92007-2002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM W WINTERNITZ JR.
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Credential | M D
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Telephone | 858-487-6440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G51348
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License Number State | CA
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