Individual
CLIVE R TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 SAN PABLO ST, LOS ANGELES, CA 90033-5313
(323) 442-5955
(323) 442-5963
Mailing address
PO BOX 51399, LOS ANGELES, CA 90089-0001
(323) 442-5955
(323) 442-5963
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A31898
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A318980
—
CA
01
—
ZZZ94714Z
BLUE SHIELD
CA
Enumeration date
09/22/2006
Last updated
07/08/2007
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