Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A29579 | CA |
Y | 208600000X | Surgeon | A29579 | CA |
NPI | 1003980327 |
---|---|
Provider Name | Emmanuel A. Taylan |
First Address | Oakland, CA 94612-3429 |
Second Address | Stockton, CA 95210-3377 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A295790 | (05) | CA |
A25818 | (02) |