Provider Demographics
NPI:1134353444
Name:WINTER, TIMOTHY WENDELL (DO)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:WENDELL
Last Name:WINTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:11370 ANDERSON ST
Mailing Address - Street 2:#1800
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3450
Mailing Address - Country:US
Mailing Address - Phone:909-558-2154
Mailing Address - Fax:909-558-2180
Practice Address - Street 1:11370 ANDERSON ST
Practice Address - Street 2:#1800
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3450
Practice Address - Country:US
Practice Address - Phone:909-558-2154
Practice Address - Fax:909-558-2180
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2020-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS11326207W00000X
IA4303207W00000X
OK4701207W00000X
NMA-1745-13207W00000X
CA20A15051207W00000X, 207WX0110X, 207WX0109X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist