MEDICARE: TAYLOR GOOD

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	146L00000X	Paramedic	P46301	CA

General Provider Information

NPI Number	:	1790648475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR GOOD

Provider Business Mailing Address
First Line	:	4231 BALBOA AVE # 1076
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-5504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4231 BALBOA AVE # 1076
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-5504
Country	:	US
Telephone Number	:	909-263-2400
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ TAYLOR GOOD ” Practice Location

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