Physician Compare National (NPI:1851604771)

HEALTHCARE PROVIDER: CAROLYN LEE TAYLOR PHYSICIAN ASSISTANT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1851604771
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1456570696
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140919001408
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TAYLOR
	Individual professional last name
Provider First Name	CAROLYN
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ADVANCE BARIATRIC CENTER MEDICAL CORPORATION
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9739156811
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	301 N AVALON BLVD
	Group Practice or individual's line 1 address
City	WILMINGTON
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	907445801
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3106844070
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050191
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y