Individual
EMMA JEAN MILDRED TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10833 LE CONTE AVE, CHS 52-121, LOS ANGELES, CA 90095-3075
(310) 825-5420
Mailing address
10833 LE CONTE AVE, CHS 52-121, LOS ANGELES, CA 90095-3075
(310) 825-5420
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A102254
CA
207N00000X
Dermatology Physician
A102254
CA
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
A102254
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A1022540
—
CA
05
—
1356407076
—
CA
Enumeration date
12/28/2006
Last updated
08/27/2013
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