Healthcare Provider Details

I. General information

NPI: 1326166331
Provider Name (Legal Business Name): WILLIAM B TAYLOR PTA, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7425 MISSION VALLEY RD SUITE 201
SAN DIEGO CA
92108-4409
US

IV. Provider business mailing address

7425 MISSION VALLEY RD SUITE 201
SAN DIEGO CA
92108-4409
US

V. Phone/Fax

Practice location:
  • Phone: 619-291-3400
  • Fax: 619-291-9828
Mailing address:
  • Phone: 619-291-3400
  • Fax: 619-291-9828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3470
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: