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General NPI Number Information
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NPI Number | 1508948712
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Entity Type | Individual
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Provider Name | KEVIN TAYLOR P.T.
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Gender | Male
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 5475 E LA PALMA AVE STE 200
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City | ANAHEIM
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State | CA
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Zip | 92807-2075
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Country | US
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Telephone | 714-701-0479
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Fax | 714-701-1746
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Provider Business Mailing Address
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Address Line | 6263 POPLAR AVE STE 801
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City | MEMPHIS
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State | TN
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Zip | 38119-4701
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Country | US
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Telephone | 901-685-7227
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Fax | 267-321-2079
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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 | 18267
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License Number State | CA
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