Provider Demographics
NPI:1659472041
Name:OB GYN ASSOCIATES OF TURLOCK A MEDICAL GROUP INC
Entity Type:Organization
Organization Name:OB GYN ASSOCIATES OF TURLOCK A MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-634-9034
Mailing Address - Street 1:1729 N OLIVE AVE
Mailing Address - Street 2:3
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2501
Mailing Address - Country:US
Mailing Address - Phone:209-634-9034
Mailing Address - Fax:209-634-0794
Practice Address - Street 1:1729 N OLIVE AVE
Practice Address - Street 2:3
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2501
Practice Address - Country:US
Practice Address - Phone:209-634-9034
Practice Address - Fax:209-634-0794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32115207V00000X
CAG65192207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0043050Medicaid
A26700Medicare UPIN
CAZZZ21828ZMedicare ID - Type Unspecified
CAGR0043050Medicaid