Provider Demographics
NPI:1083676639
Name:WINTERNITZ, WILLIAM W JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
Last Name:WINTERNITZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12630 MONTE VISTA RD
Mailing Address - Street 2:#105
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2526
Mailing Address - Country:US
Mailing Address - Phone:858-487-6440
Mailing Address - Fax:858-487-7281
Practice Address - Street 1:12630 MONTE VISTA RD
Practice Address - Street 2:#105
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2526
Practice Address - Country:US
Practice Address - Phone:858-487-6440
Practice Address - Fax:858-487-7281
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2017-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG51348207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG513980Medicaid
A51925Medicare UPIN
CAWG51348AMedicare PIN