Healthcare Provider Details

I. General information

NPI: 1790611564
Provider Name (Legal Business Name): PRECISION SURGERY PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 W VALLEY BLVD STE 220
ALHAMBRA CA
91803-2370
US

IV. Provider business mailing address

PO BOX 5365
BEVERLY HILLS CA
90209-5365
US

V. Phone/Fax

Practice location:
  • Phone: 310-400-0645
  • Fax:
Mailing address:
  • Phone: 310-528-7622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMIE TAYLOR
Title or Position: PRESIDENT
Credential: MD
Phone: 310-528-7622