Provider Demographics
NPI:1780667790
Name:TAYLOR, DOUGLAS SCOTT (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:SCOTT
Last Name:TAYLOR
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:2516 STOCKTON BLVD
Mailing Address - Street 2:TICON II, 3RD FLOOR
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2208
Mailing Address - Country:US
Mailing Address - Phone:916-734-2781
Mailing Address - Fax:916-451-3014
Practice Address - Street 1:2521 STOCKTON BLVD
Practice Address - Street 2:PEDS HEM/ONC CLINIC, 3RD FLOOR
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2207
Practice Address - Country:US
Practice Address - Phone:916-734-2781
Practice Address - Fax:916-734-1357
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2011-12-06
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Provider Licenses
StateLicense IDTaxonomies
CAG0853522080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE91719Medicare UPIN