MEDICARE: DR. BRYNN JENNY LOUISE TAYLOR 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	207Q00000X	Family Medicine Physician	MD173709	OR
2	207Q00000X	Family Medicine Physician	A154041	CA

General Provider Information

NPI Number	:	1376886655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYNN JENNY LOUISE TAYLOR MD

Provider Business Mailing Address
First Line	:	1302 ROCKY POINT DR
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-5864
Country	:	US
Telephone Number	:	541-789-2541
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 SW RAMSEY AVE
Second Line	:	SUITE 101
City	:	GRANTS PASS
State	:	OR
Zip	:	97527-5786
Country	:	US
Telephone Number	:	541-507-2080
Fax Number	:

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

Provider Enumeration Date	:	04/04/2013
Last Update Date	:	12/21/2021

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