Derek Alan Taylor, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT34503 Issued in CA

Practice address

2711 E Coast Hwy
Suite 206
Corona del Mar, CA 92625-2104

Phone

(949) 675-2922

Fax

(949) 675-2992

NPI assigned

Mar 18, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Body Awareness Physical Therapy, Inc

  • Physical Therapist
  • Costa Mesa, CA
  • NPI 1164439915
  NPD (past)
• Newsport Physical Therapy

  • Physical Therapist
  • Corona del Mar, CA
  • NPI 1831258789
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1730350752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 E COAST HWY",
            "address_2": "SUITE 206",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 E COAST HWY",
            "address_2": "SUITE 206",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252104",
            "telephone_number": "949-675-2922",
            "fax_number": "949-675-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DEREK",
        "middle_name": "ALAN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT34503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devan Stetson
• Barry Sussman, M.D.
• Stephen Sutherland, M.D.
• Rokhsareh Roxanne Tajrishi, M.D.
• Wing CHI Tang, DPT
• Kevin Taylor, DDS
• Michael Tencati
• Tender Touch Infant Hearing, Inc
• Seda Terzyan, PHD
• Pavithra Shetty Thankachen, D.D.S

• Physical Therapist in Corona del Mar, CA
• Providers in Corona del Mar, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.