MEDICARE: DR. GARY MARSHALL TAFF 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	207P00000X	Emergency Medicine Physician	G34755	CA

General Provider Information

NPI Number	:	1467577437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY MARSHALL TAFF M.D.

Provider Business Mailing Address
First Line	:	PO BOX 458
Second Line	:	43850 BUCKHORN COVE RD EAST
City	:	LITTLE RIVER
State	:	CA
Zip	:	95456-0458
Country	:	US
Telephone Number	:	707-937-3686
Fax Number	:	707-937-1117

Provider Business Practice Location Address
First Line	:	43850 BUCKHORN COVE RD EAST
Second Line	:
City	:	LITTLE RIVER
State	:	CA
Zip	:	95456-0458
Country	:	US
Telephone Number	:	707-937-3686
Fax Number	:	707-937-1117

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/08/2007

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