Healthcare Provider Details
I. General information
NPI: 1548122864
Provider Name (Legal Business Name): BARON AND TAYLOR PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1190 BAKER ST STE 103
COSTA MESA CA
92626-4105
US
IV. Provider business mailing address
1190 BAKER ST STE 103
COSTA MESA CA
92626-4105
US
V. Phone/Fax
- Phone: 714-668-2525
- Fax: 714-668-2530
- Phone: 714-668-2525
- Fax: 714-668-2530
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080A0000X |
| Taxonomy | Pediatric Adolescent Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
R
TAYLOR
Title or Position: PARTNER
Credential: MD
Phone: 714-904-8358