Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 25038 | CA |
NPI | 1427199397 |
---|---|
Provider Name | Patrick K Turley |
First Address | Manhattan Beach, CA 90266-3953 |
Second Address | Hawthorne, CA 90250-6656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 08/07/2007 |