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General NPI Number Information
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NPI Number | 1225013162
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Entity Type | Individual
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Provider Name | TIFFANY M TAYLOR PT
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Gender | Female
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 891 KUHN DR # 117
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City | CHULA VISTA
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State | CA
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Zip | 91914-3551
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Country | US
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Telephone | 619-656-5176
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Fax | 619-656-5173
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Provider Business Mailing Address
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Address Line | 5962 LA PLACE COURT SUITE 170
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City | CARLSBAD
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State | CA
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Zip | 92008
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Country | US
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Telephone | 800-929-4776
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Fax | 760-931-8370
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 24779
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License Number State | CA
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