Provider Demographics
NPI:1467577437
Name:TAFF, GARY MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:MARSHALL
Last Name:TAFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GARY
Other - Middle Name:MARSHALL
Other - Last Name:TAFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:43850 BUCKHORN COVE RD EAST
Mailing Address - City:LITTLE RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95456-0458
Mailing Address - Country:US
Mailing Address - Phone:707-937-3686
Mailing Address - Fax:707-937-1117
Practice Address - Street 1:43850 BUCKHORN COVE RD EAST
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:CA
Practice Address - Zip Code:95456-0458
Practice Address - Country:US
Practice Address - Phone:707-937-3686
Practice Address - Fax:707-937-1117
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34755207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine