MEDICARE: DIANE WINTZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	138581	CA

General Provider Information

NPI Number	:	1164721932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE WINTZ MD

Provider Business Mailing Address
First Line	:	7930 FROST ST STE 204
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2739
Country	:	US
Telephone Number	:	858-939-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	7930 FROST ST STE 204
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2739
Country	:	US
Telephone Number	:	858-939-3200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2011
Last Update Date	:	03/08/2024

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