Provider Demographics
NPI:1992798870
Name:WINKIELMAN, ADA M (MD)
Entity type:Individual
Prefix:DR
First Name:ADA
Middle Name:M
Last Name:WINKIELMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:18364 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3502
Mailing Address - Country:US
Mailing Address - Phone:818-345-7122
Mailing Address - Fax:818-345-7448
Practice Address - Street 1:18364 CLARK ST
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3502
Practice Address - Country:US
Practice Address - Phone:818-345-7122
Practice Address - Fax:818-345-7448
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA81078207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI18563Medicare UPIN