MEDICARE: RANCHO MIRAGE FAMILY GROUP INC A MEDICAL CORPORATION

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	A35629	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080158581	OTHER	CA	RAILROAD MEDICARE
3	ZZZ21403Z	OTHER	CA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	ZZZ01311Z	OTHER	CA	BLUE SHIELD OF CA
4	1720011166	OTHER	CA	GROUP NPI

General Provider Information

NPI Number	:	1720011166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RANCHO MIRAGE FAMILY GROUP INC A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	39300 BOB HOPE DRIVE
Second Line	:	BANNAN BLDG., STE, 1105
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-3203
Country	:	US
Telephone Number	:	760-773-3379
Fax Number	:	760-568-3679

Provider Business Practice Location Address
First Line	:	39300 BOB HOPE DRIVE
Second Line	:	BANNAN BLDG., STE, 1105
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-3203
Country	:	US
Telephone Number	:	760-773-3379
Fax Number	:	760-568-3679

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MURRAY D. TAYLOR
Credential	:	M.D.
Telephone Number	:	760-773-3379

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	06/18/2015

Similar Medicare Providers

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Practice Location Address:

39300 BOB HOPE DR , STE B1108
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1487670220 — ALAN E. WILLIAMSON M.D.
Practice Location Address:

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1407872419 — DR. MURRAY D. TAYLOR M.D.
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39300 BOB HOPE DR , BANNAN BLDG., STE. 1105
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1386667780 — ANIBAL RAUL GAUTO M.D.
Practice Location Address:

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1538279948 — ALAN S. COIT, M.D., INC.
Practice Location Address:

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1730286600 — RANCHO MIRAGE PAIN ASSOCIATES, INC.
Practice Location Address:

39300 BOB HOPE DR , BANNAN BUILDING, SUITE 1203
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