Provider Demographics
NPI:1265456636
Name:WINKLER, HEIDI (MD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:WINKLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1496
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-1496
Mailing Address - Country:US
Mailing Address - Phone:562-760-9559
Mailing Address - Fax:562-864-4001
Practice Address - Street 1:10210 ORR AND DAY RD STE A
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3581
Practice Address - Country:US
Practice Address - Phone:562-864-4000
Practice Address - Fax:562-864-4001
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50311208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A503114OtherMEDICAL PROVIDER NUMBER
CAL01563OtherPROVIDER NUMBER
CAL01563OtherPROVIDER NUMBER