Provider Demographics
NPI:1811380587
Name:TAYLOR, GEORGE EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:EDWARD
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 1:1426 SEA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-8207
Mailing Address - Country:US
Mailing Address - Phone:949-872-1189
Mailing Address - Fax:
Practice Address - Street 1:1426 SEA RIDGE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-8207
Practice Address - Country:US
Practice Address - Phone:949-872-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24957207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology