Provider Demographics
NPI:1326434945
Name:TAYLOR, LARRY JAMES II (OTR/L)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:JAMES
Last Name:TAYLOR
Suffix:II
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18419 E BENBOW ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-2724
Mailing Address - Country:US
Mailing Address - Phone:626-391-7357
Mailing Address - Fax:
Practice Address - Street 1:125 W SIERRA MADRE AVE
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2023
Practice Address - Country:US
Practice Address - Phone:626-391-7357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3970-26225XP0019X
CA7843225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation