Provider Demographics
NPI:1073959268
Name:TAYLOR, AFTON C
Entity Type:Individual
Prefix:DR
First Name:AFTON
Middle Name:C
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:AFTON
Other - Middle Name:LUCILLE
Other - Last Name:CONDIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1895 E CALIFORNIA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-1246
Mailing Address - Country:US
Mailing Address - Phone:626-795-5500
Mailing Address - Fax:
Practice Address - Street 1:1895 E CALIFORNIA BLVD
Practice Address - Street 2:
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-1246
Practice Address - Country:US
Practice Address - Phone:626-795-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAFE27777207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology