Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | G44560 | CA |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | G44560 | CA |
NPI | 1013077569 |
---|---|
Provider Name | Janet Winikoff |
First Address | Culver City, CA 90230-6643 |
Second Address | Santa Monica, CA 90404-2189 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 19/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013077569 | (05) | CA |
A49863 | (02) | CA |