Provider Demographics
NPI:1467403519
Name:TURULL, DEBRA A (DO)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:TURULL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 LAS TABLAS RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9729
Mailing Address - Country:US
Mailing Address - Phone:805-434-3818
Mailing Address - Fax:805-434-2566
Practice Address - Street 1:1050 LAS TABLAS RD
Practice Address - Street 2:SUITE 2
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9729
Practice Address - Country:US
Practice Address - Phone:805-434-3818
Practice Address - Fax:805-434-2566
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5980207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX59800Medicaid
CA00AX59800Medicaid
CA20A5980Medicare ID - Type Unspecified