Provider Demographics
NPI:1396409124
Name:TAYLOR, LINH (DTCM)
Entity Type:Individual
Prefix:DR
First Name:LINH
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 SANTA LUCIA DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5229
Mailing Address - Country:US
Mailing Address - Phone:310-926-6106
Mailing Address - Fax:
Practice Address - Street 1:2505 SAMARITAN DR STE 305
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4011
Practice Address - Country:US
Practice Address - Phone:408-560-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-27
Last Update Date:2022-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19254171100000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19254OtherLICENSE NUMBER
CAD5055987OtherDRIVER LICENSE