Provider Demographics
NPI:1154457380
Name:TAYLOR, KOBY (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:KOBY
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 CANYON VIEW DR STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:UT
Mailing Address - Zip Code:84765-5672
Mailing Address - Country:US
Mailing Address - Phone:435-703-9680
Mailing Address - Fax:855-853-3465
Practice Address - Street 1:1100 CANYON VIEW DR STE C
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:UT
Practice Address - Zip Code:84765-5672
Practice Address - Country:US
Practice Address - Phone:435-703-9680
Practice Address - Fax:855-853-3465
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3332341835G0303X, 1835N1003X, 1835P1200X
UT333234-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy