MEDICARE: DR. JAMES DANIEL TAFT D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	192431	NY
2	207N00000X	Dermatology Physician	20A6512	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053308239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DANIEL TAFT D.O.

Provider Business Mailing Address
First Line	:	6399 SAN IGNACIO AVE STE 120
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1215
Country	:	US
Telephone Number	:	408-369-5620
Fax Number	:

Provider Business Practice Location Address
First Line	:	2438 N PONDEROSA DR STE C105
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-2465
Country	:	US
Telephone Number	:	805-388-2068
Fax Number	:	805-484-7700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	12/04/2020

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Directions to “ DR. JAMES DANIEL TAFT D.O.” Practice Location

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