Provider Demographics
NPI:1528162989
Name:TAYLOR, MELISSA A (DO)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1901 TOWN AND COUNTRY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3611
Mailing Address - Country:US
Mailing Address - Phone:951-808-6250
Mailing Address - Fax:951-738-9954
Practice Address - Street 1:1901 TOWN AND COUNTRY DR STE 104
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-3611
Practice Address - Country:US
Practice Address - Phone:951-737-8141
Practice Address - Fax:951-817-1759
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2021-03-11
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Provider Licenses
StateLicense IDTaxonomies
CA20A7112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A7112OtherLIC #