Provider Demographics
NPI:1780670422
Name:WINCHESTER, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:WINCHESTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1010 HURLEY WAY
Mailing Address - Street 2:#475
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-3215
Mailing Address - Country:US
Mailing Address - Phone:916-561-6818
Mailing Address - Fax:916-561-4263
Practice Address - Street 1:5301 F ST
Practice Address - Street 2:#117
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3226
Practice Address - Country:US
Practice Address - Phone:916-733-1788
Practice Address - Fax:916-733-1787
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2007-07-12
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Provider Licenses
StateLicense IDTaxonomies
CAG34163207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G341630Medicaid
CAP00082832OtherRAILROAD MEDICARE PIN
CAP00082832OtherRAILROAD MEDICARE PIN
CAA45808Medicare UPIN