Provider Demographics
NPI:1003120676
Name:TAYLOR, ISHA SAEEDA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MRS
First Name:ISHA
Middle Name:SAEEDA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:ISHA
Other - Middle Name:SAEEDA
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:27480 AROMATIC CT
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-4760
Mailing Address - Country:US
Mailing Address - Phone:323-702-2037
Mailing Address - Fax:
Practice Address - Street 1:27480 AROMATIC CT
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-4760
Practice Address - Country:US
Practice Address - Phone:323-702-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20810363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant