Healthcare Provider Details

I. General information

NPI: 1376742973
Provider Name (Legal Business Name): CANDICE ELIZABETH TAYLOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N MAIN ST
SANTA ANA CA
92701-3576
US

IV. Provider business mailing address

3800 W CHAPMAN AVE STE 2200
ORANGE CA
92868-1612
US

V. Phone/Fax

Practice location:
  • Phone: 657-282-6355
  • Fax:
Mailing address:
  • Phone: 714-456-8470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA107657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: