MEDICARE: DR. TAYLOR R POLLEI M.D.

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	207YS0123X	Facial Plastic Surgery Physician	43416	AZ
2	207YS0123X	Facial Plastic Surgery Physician	275033	NY
3	207YS0123X	Facial Plastic Surgery Physician	135518	CA

General Provider Information

NPI Number	:	1366676942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAYLOR R POLLEI M.D.

Provider Business Mailing Address
First Line	:	26691 PLAZA STE 200
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-8582
Country	:	US
Telephone Number	:	949-998-2020
Fax Number	:	949-998-2021

Provider Business Practice Location Address
First Line	:	26691 PLAZA STE 200
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-8582
Country	:	US
Telephone Number	:	949-998-2020
Fax Number	:	949-998-2020

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

Provider Enumeration Date	:	05/11/2009
Last Update Date	:	04/26/2023

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