Provider Demographics
NPI:1285720201
Name:TAYLOR, LINDSEY MARIKO (DPT)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:MARIKO
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:LINDSEY
Other - Middle Name:MARIKO
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:2800 PLAZA DEL AMO
Mailing Address - Street 2:UNIT 213
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-7388
Mailing Address - Country:US
Mailing Address - Phone:310-963-3883
Mailing Address - Fax:
Practice Address - Street 1:15446 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-4319
Practice Address - Country:US
Practice Address - Phone:310-217-5378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32087225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT32087AMedicare UPIN
CAW16657Medicare UPIN