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General NPI Number Information
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NPI Number | 1326434945
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Entity Type | Individual
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Provider Name | LARRY JAMES TAYLOR II OTR/L
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Gender | Male
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 125 W SIERRA MADRE AVE
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City | AZUSA
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State | CA
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Zip | 91702-2023
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Country | US
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Telephone | 626-391-7357
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Fax |
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Provider Business Mailing Address
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Address Line | 18419 E BENBOW ST
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City | COVINA
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State | CA
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Zip | 91722-2724
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Country | US
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Telephone | 626-391-7357
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Fax |
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 3970-26
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 7843
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License Number State | CA
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