Provider Demographics
NPI:1326553132
Name:TAY, ROLAND (ND)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:
Last Name:TAY
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 W. LOMITA BLVD, STE. 303-B
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2085
Mailing Address - Country:US
Mailing Address - Phone:310-988-8403
Mailing Address - Fax:310-634-0389
Practice Address - Street 1:1403 LOMITA BLVD STE 303B
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2085
Practice Address - Country:US
Practice Address - Phone:310-988-8403
Practice Address - Fax:310-634-0389
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-04
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4126175F00000X
CA952175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath