Individual
DR. TAYLOR A. DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103
(858) 657-8322
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A86650
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A866500
—
CA
Enumeration date
12/23/2005
Last updated
07/05/2018
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