Provider Demographics
NPI:1710963608
Name:TURKIS, MARTIN EDWARD SR (OD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:EDWARD
Last Name:TURKIS
Suffix:SR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2773 HARRIS ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4866
Mailing Address - Country:US
Mailing Address - Phone:707-445-4126
Mailing Address - Fax:707-445-1759
Practice Address - Street 1:2773 HARRIS ST
Practice Address - Street 2:SUITE H
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4866
Practice Address - Country:US
Practice Address - Phone:707-445-4126
Practice Address - Fax:707-445-1759
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT6130TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0061300Medicaid
CA4981950001Medicare NSC
CASDOO61302Medicare ID - Type UnspecifiedPPIN
CAY00986Medicare UPIN
CAT10239Medicare UPIN
CASD0061300Medicaid