MEDICARE: JACOB M WINTER MD, PHD

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	207R00000X	Internal Medicine Physician	A207456	CA

General Provider Information

NPI Number	:	1417686668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB M WINTER MD, PHD

Provider Business Mailing Address
First Line	:	1471 27TH AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94122-3225
Country	:	US
Telephone Number	:	801-419-8575
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 PARNASSUS AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-2202
Country	:	US
Telephone Number	:	415-476-1000
Fax Number	:

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

Provider Enumeration Date	:	06/05/2022
Last Update Date	:	06/05/2026

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