Healthcare Provider Details

I. General information

NPI: 1447522974
Provider Name (Legal Business Name): IVAN M TURPIN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W STEWART DR SUITE 610
ORANGE CA
92868-3854
US

IV. Provider business mailing address

1310 W STEWART DR SUITE 610
ORANGE CA
92868-3854
US

V. Phone/Fax

Practice location:
  • Phone: 714-997-4300
  • Fax: 714-997-5759
Mailing address:
  • Phone: 714-997-4300
  • Fax: 714-997-5759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberG22754
License Number StateCA

VIII. Authorized Official

Name: CARLA F WESTMAN
Title or Position: INSURANCE MANAGER
Credential:
Phone: 714-997-4300