Provider Demographics
NPI:1558640953
Name:WINTER, GRETCHEN EILEEN (PHD, DO)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:EILEEN
Last Name:WINTER
Suffix:
Gender:F
Credentials:PHD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 EL CAMINO REAL STE 101
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4216
Mailing Address - Country:US
Mailing Address - Phone:805-539-2031
Mailing Address - Fax:805-539-2032
Practice Address - Street 1:6955 EL CAMINO REAL STE 101
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422
Practice Address - Country:US
Practice Address - Phone:805-539-2031
Practice Address - Fax:805-539-2032
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12705207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine