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General NPI Number Information
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NPI Number | 1851422281
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Entity Type | Organization
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Legal Business Name | CHARLES TAYLOR MEDICAL CORP
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 10722 ARROW RTE STE 512
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4840
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Country | US
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Telephone | 818-913-9940
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Fax | 562-349-0457
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Provider Business Mailing Address
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Address Line | 65 PINE AVE # 246
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City | LONG BEACH
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State | CA
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Zip | 90802-4718
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Country | US
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Telephone | 760-217-0492
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Fax | 562-349-0457
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES TAYLOR
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Credential |
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Telephone | 760-217-0492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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