Healthcare Provider Details

I. General information

NPI: 1932295714
Provider Name (Legal Business Name): JOSEPH CREE TAYLOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3942 PEARL ROAD
POLLOCK PINES CA
95726
US

IV. Provider business mailing address

3942 PEARL ROAD
POLLOCK PINES CA
95726
US

V. Phone/Fax

Practice location:
  • Phone: 530-644-4069
  • Fax:
Mailing address:
  • Phone: 530-644-4069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC30328
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: