Provider Demographics
NPI:1205391356
Name:TAYLOR, ANTOINE VERNELL SR (NP)
Entity type:Individual
Prefix:MR
First Name:ANTOINE
Middle Name:VERNELL
Last Name:TAYLOR
Suffix:SR
Gender:M
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:4701 W IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90304-2630
Mailing Address - Country:US
Mailing Address - Phone:310-910-0660
Mailing Address - Fax:424-512-0206
Practice Address - Street 1:4701 W IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90304-2630
Practice Address - Country:US
Practice Address - Phone:310-910-0660
Practice Address - Fax:424-512-0206
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95010879363LF0000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services