Provider Demographics
NPI:1598746950
Name:WINGET, LEI H (MD)
Entity Type:Individual
Prefix:
First Name:LEI
Middle Name:H
Last Name:WINGET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LEI
Other - Middle Name:
Other - Last Name:HAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:CUTTEN
Mailing Address - State:CA
Mailing Address - Zip Code:95534-0073
Mailing Address - Country:US
Mailing Address - Phone:707-445-5170
Mailing Address - Fax:707-444-3375
Practice Address - Street 1:2700 DOLBEER ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4736
Practice Address - Country:US
Practice Address - Phone:707-269-4253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90467207RG0300X, 208M00000X, 207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABG436AMedicare PIN
WII15229Medicare UPIN