MEDICARE: TAYLOR WECKSTEIN MD

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	207R00000X	Internal Medicine Physician	PTL18755	CA

General Provider Information

NPI Number	:	1306739966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR WECKSTEIN MD

Provider Business Mailing Address
First Line	:	505 PARNASSUS AVE # M1480
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-2204
Country	:	US
Telephone Number	:	231-342-8094
Fax Number	:

Provider Business Practice Location Address
First Line	:	13367 BLUFF RD
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-8451
Country	:	US
Telephone Number	:	231-342-8094
Fax Number	:

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

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	01/13/2026

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