Provider Demographics
NPI:1336176312
Name:TAYLOR, CECILLE G (MD)
Entity Type:Individual
Prefix:
First Name:CECILLE
Middle Name:G
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1615 CREEKSIDE DR
Mailing Address - Street 2:#110
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3491
Mailing Address - Country:US
Mailing Address - Phone:916-983-4550
Mailing Address - Fax:916-983-8569
Practice Address - Street 1:1561 CREEKSIDE DR
Practice Address - Street 2:#160
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630
Practice Address - Country:US
Practice Address - Phone:916-983-4550
Practice Address - Fax:916-983-8569
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2011-01-05
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Provider Licenses
StateLicense IDTaxonomies
CAG067853207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0042245Medicaid
CAZZZ399052Medicare ID - Type Unspecified
CAGR0042245Medicaid