Provider Demographics
NPI:1487643193
Name:TAYLOR, ROBERT ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANTHONY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 N ROSE AVE STE 470
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-7659
Mailing Address - Country:US
Mailing Address - Phone:805-988-2775
Mailing Address - Fax:805-278-1220
Practice Address - Street 1:1700 N ROSE AVE STE 470
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7659
Practice Address - Country:US
Practice Address - Phone:805-988-2775
Practice Address - Fax:805-278-1220
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN496222084N0400X, 2084V0102X
CAC1301962084N0400X, 208600000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA37444OtherWELLMARK BCBS
IA0446344Medicaid
I18405Medicare UPIN
IA0446344Medicaid