Taylor, Emma Jean Mildred

Taylor, Emma Jean Mildred is an individual health care provider with primary practice located at 10833 Le Conte Ave Chs 52-121, Los Angeles CA 90095-3075. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatopathology is her primary health care specialty. Taylor, Emma Jean Mildred can be contacted via phone (310) 825-5420.

Contact Information

Primary practice address
10833 Le Conte Ave Chs 52-121 Los Angeles CA 90095-3075
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A102254 California
Allopathic & Osteopathic Physicians / Dermatology 207N00000X A102254 California
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X A102254 California

Profile Details

NPI number 1356407076
LBN Legal business name Taylor, Emma Jean Mildred
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Aug 27th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356407076 NPPES
California MEDICAID 1356407076
California MEDICAID 0A1022540

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