MEDICARE: DR. JOSEPH CREE 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	174400000X	Specialist	C30328	CA

General Provider Information

NPI Number	:	1932295714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH CREE TAYLOR MD

Provider Business Mailing Address
First Line	:	3942 PEARL ROAD
Second Line	:
City	:	POLLOCK PINES
State	:	CA
Zip	:	95726
Country	:	US
Telephone Number	:	530-644-4069
Fax Number	:

Provider Business Practice Location Address
First Line	:	3942 PEARL ROAD
Second Line	:
City	:	POLLOCK PINES
State	:	CA
Zip	:	95726
Country	:	US
Telephone Number	:	530-644-4069
Fax Number	:

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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