Provider Demographics
NPI:1942311287
Name:NOWINSKI, STANLEY T (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:T
Last Name:NOWINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:855-771-0335
Mailing Address - Fax:
Practice Address - Street 1:969 PLUMAS ST
Practice Address - Street 2:SUITE 116
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4011
Practice Address - Country:US
Practice Address - Phone:530-749-3585
Practice Address - Fax:530-749-3607
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA40029207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942311287Medicaid
CAP00785499OtherRAILROAD MEDICARE
CAAN2200816OtherDEA
CAA29028Medicare UPIN
CACC501ZMedicare PIN
CAP00785499OtherRAILROAD MEDICARE