=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033294905
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MURRAY TAUBMAN O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2006
-----------------------------------------------------
Last Update Date | 02/03/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12568 VALLEY VIEW ST
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92845-2006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-894-3353
-----------------------------------------------------
Fax | 714-373-0670
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12568 VALLEY VIEW ST
-----------------------------------------------------
City | GARDEN GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92845-2006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-894-3353
-----------------------------------------------------
Fax | 714-373-0670
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 6125T
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------