Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | C027108 | CA |
Y | 111NI0900X | Internist | C027108 | CA |
N | 207RG0300X | Geriatric Medicine | C027108 | CA |
NPI | 1013020908 |
---|---|
Provider Name | Robert Harlan Wintroub |
First Address | Los Angeles, CA 90049-3802 |
Second Address | Los Angeles, CA 90049-3802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 15/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A33282 | (02) |