Individual
DANETTE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
855 MANHATTAN BEACH BLVD, SUITE 102, MANHATTAN BEACH, CA 90266-4965
(310) 939-7858
(310) 939-7842
Mailing address
3105 LOMITA BLVD, TORRANCE, CA 90505-5108
(310) 784-4926
(310) 891-6793
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A67159
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A671590
BLUE SHIELD
—
Enumeration date
05/16/2006
Last updated
11/11/2021
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