Provider Demographics
NPI:1265655203
Name:WINSTON, DREW JOHN (MD)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:JOHN
Last Name:WINSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:13351D RIVERSIDE DR
Mailing Address - Street 2:# 240
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2508
Mailing Address - Country:US
Mailing Address - Phone:818-772-2197
Mailing Address - Fax:818-817-9823
Practice Address - Street 1:10833 LECONTE AVE
Practice Address - Street 2:UCHA MEDICAL CENTER DEPT OF MEDICINE ROOM 42 121 CHS
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024
Practice Address - Country:US
Practice Address - Phone:310-825-6264
Practice Address - Fax:310-206-5511
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG34770207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G347701Medicaid
CAG34770AMedicare ID - Type Unspecified
CA00G347701Medicaid