Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 297595 | CA |
Y | 213ES0000X | Sports Medicine | 297595 | CA |
NPI | 1194369868 |
---|---|
Provider Name | Channing Turner |
First Address | Huntington Beach, CA 92648-1901 |
Second Address | Huntington Beach, CA 92648-1901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2019 |
Last Update Date | 05/11/2019 |