Organization Active NPI

Mark R Winkler MD PA Professional Corporation

  • Internal Medicine Physician
  • Moorpark, CA
National Provider Identifier
1336366202
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G67756 Issued in CA
Legal business name
MARK R WINKLER MD PA PROFESSIONAL CORPORATION
Practice address
14366 Shawnee St
Moorpark, CA 93021-3569
Phone
(818) 882-5375
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Winkler
Title
President
Phone
(818) 882-5375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G67756 CA Primary

Addresses

Primary practice location

14366 Shawnee St
Moorpark, CA 93021-3569

Mailing address

14366 Shawnee St
Moorpark, CA 93021-3569
Phone (818) 882-5375

Other identifiers 1

IdentifierTypeStateIssuer
00G77560MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1336366202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14366 SHAWNEE ST",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930213569",
            "telephone_number": "818-882-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14366 SHAWNEE ST",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930213569",
            "telephone_number": "818-882-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R WINKLER MD PA PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "WINKLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-882-5375"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G67756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G77560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorpark, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.