Provider Demographics
NPI:1801825328
Name:TAYLOR, JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1155 ANDERSEN DR
Mailing Address - Street 2:STE 1107
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-5336
Mailing Address - Country:US
Mailing Address - Phone:415-455-0914
Mailing Address - Fax:415-454-4315
Practice Address - Street 1:1155 ANDERSEN DR
Practice Address - Street 2:STE 1107
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-5336
Practice Address - Country:US
Practice Address - Phone:415-455-0914
Practice Address - Fax:415-454-4315
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2013-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG62102208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE82794Medicare UPIN