Individual
MARK WINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2330 UTAH AVE STE 200, EL SEGUNDO, CA 90245-4817
(281) 766-0959
Mailing address
3612 GRANT CT, FLOWER MOUND, TX 75022-5117
(920) 574-0143
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
12215487-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
ME165038
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2016
Last updated
01/15/2025
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