Provider Demographics
NPI:1750511846
Name:TURLOCK EMG & NEUROLOGY INC.
Entity Type:Organization
Organization Name:TURLOCK EMG & NEUROLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-202-3762
Mailing Address - Street 1:1051 E TUOLUMNE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-1546
Mailing Address - Country:US
Mailing Address - Phone:209-202-3762
Mailing Address - Fax:209-343-2425
Practice Address - Street 1:1051 E TUOLUMNE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-1546
Practice Address - Country:US
Practice Address - Phone:209-202-3762
Practice Address - Fax:209-343-2425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CK637AOtherPTAN
1063529519OtherNPI
1750511846OtherNPI
BY423YOtherPTAN INDIVIDUAL
CA6339039Medicaid
CK637AOtherPTAN
BY423YMedicare PIN
CK637AMedicare PIN