Provider Demographics
NPI:1861460768
Name:TAYLOR, GRETCHEN COLLINS (M D)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:COLLINS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 ORA AVO TER
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-6511
Mailing Address - Country:US
Mailing Address - Phone:760-599-5867
Mailing Address - Fax:
Practice Address - Street 1:PSC 477 BOX 555191
Practice Address - Street 2:US NAVAL HOSPITAL CAMP PENDLETON
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG68857207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology