Gary Marshall Taff, M.D.
Individual provider Active NPI Emergency Medicine Physician · Little River, CA
NPI 1467577437 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1467577437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- G34755 (CA)
- Practice address
- 43850 Buckhorn Cove Rd East
Little River, CA 95456-0458 - Phone
- (707) 937-3686
- Fax
- (707) 937-1117
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160511001387 | CA | Order and Referring Only - Emergency Medicine |
9234428442 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G34755 | CA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primecare Medical Group | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | G34755 | CA | Yes |
Addresses
Primary practice location
43850 Buckhorn Cove Rd East
Little River, CA 95456-0458
Mailing address
PO Box 458
43850 Buckhorn Cove Rd East
Little River, CA 95456-0458
Phone (707) 937-3686
Other names
- Dr. Gary Marshall Taff
Other providers in Little River, CA
All providers in Little River, CA · Emergency Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.