Provider Demographics
NPI:1699880781
Name:TURNER, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10833 LE CONTE AVE
Mailing Address - Street 2:ROOM 37-131 CHS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1690
Mailing Address - Country:US
Mailing Address - Phone:310-825-8599
Mailing Address - Fax:310-206-8622
Practice Address - Street 1:10833 LE CONTE AVE
Practice Address - Street 2:ROOM 37-131 CHS
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1690
Practice Address - Country:US
Practice Address - Phone:310-825-8599
Practice Address - Fax:310-206-8622
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77908207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1699880781Medicaid
CA1699880781Medicaid
CAI24422Medicare UPIN