Individual
DR. BENJAMIN WINARKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10820 183RD ST, CERRITOS, CA 90703-8013
(800) 823-4040
Mailing address
10820 183RD ST, CERRITOS, CA 90703-8013
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A115005
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A115005
MEDICAL BOARD OF CALIFORNIA CERTIFICATE NUMBER
CA
Enumeration date
04/24/2012
Last updated
12/01/2021
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