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Individual

SUSAN A. TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
711-045 CENTER ROAD, CALIFORNIA CORRECTIONAL CENTER, SUSANVILLE, CA 96130
(530) 257-2181
Mailing address
701-670 RICHMOND RD E, SUSANVILLE, CA 96130-5020
(530) 251-2136

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
15318
CA

Other

Enumeration date
08/06/2007
Last updated
08/06/2007
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