Healthcare Provider Details

I. General information

NPI: 1104357763
Provider Name (Legal Business Name): TAYLOR EVERETT HOBSON M.D., M.B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18133 VENTURA BLVD STE 302
TARZANA CA
91356-3645
US

IV. Provider business mailing address

18133 VENTURA BLVD STE 302
TARZANA CA
91356-3645
US

V. Phone/Fax

Practice location:
  • Phone: 818-264-3344
  • Fax:
Mailing address:
  • Phone: 818-264-3344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA186790
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: