Individual
JOHAN WINOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2218 KAUSEN DR STE 103, ELK GROVE, CA 95758-7178
(916) 683-8774
(916) 683-8777
Mailing address
1111 EXPOSITION BLVD STE 300, SACRAMENTO, CA 95815-4324
(916) 929-8564
(916) 929-4529
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
35090745
OH
207RN0300X
Nephrology Physician
Primary
A116149
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0015060
—
CA
01
—
P00981485
RAILROAD MEDICARE
—
Enumeration date
05/12/2006
Last updated
06/13/2025
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