Provider Demographics
NPI:1174741631
Name:WINKLE, RICHARD JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOHN
Last Name:WINKLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11741 VALLEY VIEW ST
Mailing Address - Street 2:A
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5500
Mailing Address - Country:US
Mailing Address - Phone:714-897-1071
Mailing Address - Fax:714-897-0125
Practice Address - Street 1:11741 VALLEY VIEW ST
Practice Address - Street 2:A
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5500
Practice Address - Country:US
Practice Address - Phone:714-897-1071
Practice Address - Fax:714-799-2096
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYG8441208600000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G84410Medicaid
CAWG8441AMedicare ID - Type Unspecified
CA000G84410Medicaid