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NPI Code Detail

MEDICARE: DR. GRETCHEN EILEEN WINTER PH.D., D.O.

MEDICARE: DR. GRETCHEN EILEEN WINTER PH.D., D.O.
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
1207R00000XInternal Medicine Physician20A12705CA

General Provider Information

NPI Number : 1558640953
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GRETCHEN EILEEN WINTER PH.D., D.O.
Provider Business Mailing Address
First Line : 159 EARTHWOOD LN
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-9108
Country : US
Telephone Number : 818-593-9977
Fax Number :
Provider Business Practice Location Address
First Line : 1100 LAS TABLAS RD
Second Line :
City : TEMPLETON
State : CA
Zip : 93465-9704
Country : US
Telephone Number : 804-434-4706
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2011
Last Update Date : 01/26/2026

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