MEDICARE: MR. DANIEL E TAYLOR PERFUSIONIST

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	242T00000X	Perfusionist

General Provider Information

NPI Number	:	1164647939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL E TAYLOR PERFUSIONIST

Provider Business Mailing Address
First Line	:	1981 SCENIC RIDGE DR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709
Country	:	US
Telephone Number	:	877-520-8602
Fax Number	:

Provider Business Practice Location Address
First Line	:	1981 SCENIC RIDGE DR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-1004
Country	:	US
Telephone Number	:	877-520-8602
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	12/13/2010

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