MEDICARE: TAYLOR PHYSICAL THERAPY, INC.

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	225100000X	Physical Therapist	PT19180	CA

General Provider Information

NPI Number	:	1629048590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYLOR PHYSICAL THERAPY, INC.

Provider Business Mailing Address
First Line	:	515 SOUTH DR STE 12
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4209
Country	:	US
Telephone Number	:	650-559-0011
Fax Number	:	650-559-0012

Provider Business Practice Location Address
First Line	:	515 SOUTH DR STE 12
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4209
Country	:	US
Telephone Number	:	650-559-0011
Fax Number	:	650-559-0012

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TAYLOR MILLER
Credential	:	PT
Telephone Number	:	650-559-0011

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	06/27/2020

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