Provider Demographics
NPI:1265443956
Name:HELENE MALABED, DO & TERRENCE C. TURPEN, PA-C
Entity Type:Organization
Organization Name:HELENE MALABED, DO & TERRENCE C. TURPEN, PA-C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TURPEN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:209-223-7784
Mailing Address - Street 1:PO BOX 258
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:CA
Mailing Address - Zip Code:95642-0258
Mailing Address - Country:US
Mailing Address - Phone:209-223-7784
Mailing Address - Fax:209-223-7783
Practice Address - Street 1:601 COURT ST. SUITE 210
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2163
Practice Address - Country:US
Practice Address - Phone:209-223-7784
Practice Address - Fax:209-223-7783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0104770Medicaid
CAZZZ04022ZMedicare PIN