MEDICARE: DR. BRYAN SCOTT TAYLOR 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	207L00000X	Anesthesiology Physician	04-21832	KS
2	207L00000X	Anesthesiology Physician	G89122	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	:	1619073400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN SCOTT TAYLOR M.D.

Provider Business Mailing Address
First Line	:	210 N TUSTIN AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3807
Country	:	US
Telephone Number	:	714-347-1010
Fax Number	:	714-647-1245

Provider Business Practice Location Address
First Line	:	1330 SAN BERNARDINO RD
Second Line	:	SUITE F
City	:	UPLAND
State	:	CA
Zip	:	91786-4928
Country	:	US
Telephone Number	:	909-981-8755
Fax Number	:

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	01/15/2013

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Directions to “ DR. BRYAN SCOTT TAYLOR M.D.” Practice Location

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