Provider Demographics
NPI:1457379034
Name:TURNURE MEDICAL GROUP INC SPC
Entity Type:Organization
Organization Name:TURNURE MEDICAL GROUP INC SPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TURNURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-300-1188
Mailing Address - Street 1:6805 FIVE STAR BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-2684
Mailing Address - Country:US
Mailing Address - Phone:916-624-3500
Mailing Address - Fax:916-624-3351
Practice Address - Street 1:6805 FIVE STAR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-2684
Practice Address - Country:US
Practice Address - Phone:916-624-3500
Practice Address - Fax:916-624-3351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80859207Q00000X
CAA66121207Q00000X
CAA83419207Q00000X
CAG70114207Q00000X
CAG68651208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26454ZOtherMEDICARE GROUP PTAN