Provider Demographics
NPI:1962206946
Name:SPAUR, TAYLOR JOHN (LMT)
Entity type:Individual
Prefix:MR
First Name:TAYLOR
Middle Name:JOHN
Last Name:SPAUR
Suffix:
Gender:
Credentials:LMT
Other - Prefix:MR
Other - First Name:T. J.
Other - Middle Name:
Other - Last Name:SPAUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:1116 ELDEN AVE APT 1/2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2929
Mailing Address - Country:US
Mailing Address - Phone:818-679-5846
Mailing Address - Fax:
Practice Address - Street 1:1116 ELDEN AVE APT 1/2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2929
Practice Address - Country:US
Practice Address - Phone:818-679-5846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95069225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist