Provider Demographics
NPI:1386648780
Name:TURLOCK WOMENS MED GRP INC
Entity Type:Organization
Organization Name:TURLOCK WOMENS MED GRP INC
Other - Org Name:JAMES T LILLIGREN MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:LILLIGREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-668-2311
Mailing Address - Street 1:2141 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2011
Mailing Address - Country:US
Mailing Address - Phone:209-668-2311
Mailing Address - Fax:209-668-8627
Practice Address - Street 1:2141 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2011
Practice Address - Country:US
Practice Address - Phone:209-668-2311
Practice Address - Fax:209-668-8627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34772207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A35722Medicare UPIN