Provider Demographics
NPI:1407812142
Name:TAYLOR, JO L (MD)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 DELAWARE AVENUE
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-4007
Mailing Address - Country:US
Mailing Address - Phone:916-683-6163
Mailing Address - Fax:916-200-3834
Practice Address - Street 1:SUTTER MEDICAL CENTER, SACRAMENTO
Practice Address - Street 2:2825 CAPITOL AVENUE
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6039
Practice Address - Country:US
Practice Address - Phone:916-887-1130
Practice Address - Fax:916-887-0650
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53791207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA52599Medicare UPIN