Basic Information
| Provider Information | |||||||||
| NPI: | 1366895831 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | |||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1389 | ||||||||
| Address2: | |||||||||
| City: | FERNDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955361389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2096841680 | ||||||||
| FaxNumber: | 7079499715 | ||||||||
| Practice Location | |||||||||
| Address1: | 1523 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FORTUNA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955402430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7077262255 | ||||||||
| FaxNumber: | 7079499715 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2016 | ||||||||
| LastUpdateDate: | 08/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 16417 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.