Provider Demographics
NPI:1548673692
Name:CARLE, TAYLOR ROSE (MD)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ROSE
Last Name:CARLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:ROSE
Other - Last Name:MANTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 S RAYMOND AVE UNIT 201
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3283
Mailing Address - Country:US
Mailing Address - Phone:424-314-0196
Mailing Address - Fax:424-314-0199
Practice Address - Street 1:630 S RAYMOND AVE UNIT 201
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3283
Practice Address - Country:US
Practice Address - Phone:424-314-0196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA161283207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology