MEDICARE: TAYFAM INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	64650803	CA

General Provider Information

NPI Number	:	1003056573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYFAM INCORPORATED

Provider Business Mailing Address
First Line	:	1952 W 78TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-2338
Country	:	US
Telephone Number	:	323-751-5100
Fax Number	:	323-751-5112

Provider Business Practice Location Address
First Line	:	2405 W FLORENCE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90043-5104
Country	:	US
Telephone Number	:	323-751-5100
Fax Number	:	323-751-5112

Authorized Official
Title or Position	:	CEO
Name	:	MRS. MAKIESHA JO FRANKLIN
Credential	:
Telephone Number	:	310-920-7604

Provider Enumeration Date	:	02/24/2009
Last Update Date	:	02/24/2009

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Directions to “TAYFAM INCORPORATED ” Practice Location

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