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General NPI Number Information
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NPI Number | 1437217767
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Entity Type | Individual
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Provider Name | JAMIE LATIOLAIS TAYLOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 12/06/2019
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Provider Practice Location Address
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Address Line | 2040 E MARIPOSA AVE
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City | EL SEGUNDO
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State | CA
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Zip | 90245
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Country | US
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Telephone | 310-400-0645
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Fax | 424-270-6232
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Provider Business Mailing Address
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Address Line | 2040 E MARIPOSA AVE
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City | EL SEGUNDO
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State | CA
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Zip | 90245-5027
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Country | US
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Telephone | 310-400-0645
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Fax | 424-270-6232
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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 | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | A86675
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A86675
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License Number State | CA
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