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Individual

BRUCE KENNETH TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2528 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080-4327
(530) 528-6100
(530) 528-6146
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
30395
CO
207X00000X
Orthopaedic Surgery Physician
Primary
C50150
CA
207X00000X
Orthopaedic Surgery Physician
MD168405
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01303957
CO
Enumeration date
06/29/2006
Last updated
10/30/2018
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