MEDICARE: JAMES 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	208D00000X	General Practice Physician	G62102	CA

General Provider Information

NPI Number	:	1801825328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES TAYLOR M.D.

Provider Business Mailing Address
First Line	:	1155 ANDERSEN DR
Second Line	:	STE 1107
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-5336
Country	:	US
Telephone Number	:	415-455-0914
Fax Number	:	415-454-4315

Provider Business Practice Location Address
First Line	:	1155 ANDERSEN DR
Second Line	:	STE 1107
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-5336
Country	:	US
Telephone Number	:	415-455-0914
Fax Number	:	415-454-4315

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	01/16/2013

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