Individual
MISS STACIE KARENE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
446 ALTA RD STE 6100, SAN DIEGO, CA 92158-0001
(619) 671-6546
(671) 671-6555
Mailing address
405 SANIBELLE CIR UNIT 28, CHULA VISTA, CA 91910-7546
(619) 405-4222
(619) 671-6555
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA14581
CA
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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