Provider Demographics
NPI:1083635486
Name:TURK, CLIFFORD P IV (MD)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:P
Last Name:TURK
Suffix:IV
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 1:3200 21ST ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3108
Mailing Address - Country:US
Mailing Address - Phone:661-334-1958
Mailing Address - Fax:661-324-4095
Practice Address - Street 1:420 34TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2237
Practice Address - Country:US
Practice Address - Phone:661-327-1792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94827207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A948270Medicaid
CA00A948270Medicaid
CA00A948270Medicare PIN
CAZZZ21365ZMedicare PIN
CAZZZ15998ZMedicare PIN
CAI56904Medicare UPIN
CAZZZ21366ZMedicare PIN
CAP00336860Medicare PIN
CAZZZ15999ZMedicare PIN
CAZZZ21367ZMedicare PIN
CACD4582Medicare PIN