Provider Demographics
NPI:1780763631
Name:WINKLER, RICHARD MARK (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MARK
Last Name:WINKLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:R. MARK
Other - Middle Name:
Other - Last Name:WINKLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2605 MIRA FLORES DR
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-3648
Mailing Address - Country:US
Mailing Address - Phone:209-669-3400
Mailing Address - Fax:209-669-8495
Practice Address - Street 1:1000 DELBON AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2008
Practice Address - Country:US
Practice Address - Phone:209-669-3400
Practice Address - Fax:209-669-8495
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G601370207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA90028Medicare UPIN