Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G20812 | CA |
NPI | 1003895822 |
---|---|
Provider Name | Michael S Winston |
First Address | Encino, CA 91426-0793 |
Second Address | Glendale, CA 91206-2127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 12/10/2011 |