Organization
BSTMD, INCORPORATED
Active
Organization
BSTMD, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN S TAYLOR M.D. (MEDICAL DIRECTOR)
(805) 654-0926
Entity
Organization
Contact information
Practice address
3585 MAPLE ST, SUITE # 205, VENTURA, CA 93003-3504
(805) 654-0926
(805) 654-0949
Mailing address
3585 MAPLE ST, SUITE # 205, VENTURA, CA 93003-3504
(805) 654-0926
(805) 654-0949
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G75540
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G75540
LICENSE
CA
Enumeration date
08/13/2014
Last updated
08/13/2014
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