Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | C38810 | CA |
NPI | 1144278052 |
---|---|
Provider Name | Robert W. Taylor |
First Address | Sacramento, CA 95814-6414 |
Second Address | Atascadero, CA 93422-5808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 17/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C388100 | (05) | CA |
930106261 | MEDICARE RAILROAD (01) | CA |
F60286 | (02) | CA |