Healthcare Provider Details

I. General information

NPI: 1104747781
Provider Name (Legal Business Name): TAYLOR GABRIELLE VERDIN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 IMPERIAL HWY
DOWNEY CA
90242-3456
US

IV. Provider business mailing address

2211 JULIET ST
LOS ANGELES CA
90007-1516
US

V. Phone/Fax

Practice location:
  • Phone: 562-385-7111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number308657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: