Provider Demographics
NPI:1730192063
Name:WINKLER, BRYAN L (MD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:L
Last Name:WINKLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 745859
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-5859
Mailing Address - Country:US
Mailing Address - Phone:704-362-5391
Mailing Address - Fax:
Practice Address - Street 1:8750 WILSHIRE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2708
Practice Address - Country:US
Practice Address - Phone:310-689-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME947092085R0202X
AZ337712085R0202X
CAA897522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology