Provider Demographics
NPI:1821171000
Name:WINNICK, JAMES ERNEST (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ERNEST
Last Name:WINNICK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-2946
Mailing Address - Country:US
Mailing Address - Phone:209-847-3051
Mailing Address - Fax:209-951-2348
Practice Address - Street 1:141 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361
Practice Address - Country:US
Practice Address - Phone:209-847-3051
Practice Address - Fax:209-951-2348
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12016TLG152WC0802X
CA12016152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MW0655386OtherDEA
U71428Medicare UPIN
U71428Medicare UPIN