Most Relevant Information
Provider Data
| NPI Number: | 1003454380 |
| Provider Name: | TAYELOR SHAWN WALLIN |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/17/2019 |
| Last Updated: | 06/20/2024 |
Provider Practice Location
12141 BROOKHURST ST STE 201
GARDEN GROVE
CA
928402865
Practice Location Phone/Fax
| Phone: | 6572617140 |
| Fax: | 7149221032 |
Provider Mailing Location
12141 BROOKHURST ST STE 201
GARDEN GROVE
CA
928402865
Provider Mailing Phone/Fax
| Phone: | 6572617140 |
| Fax: | 7149221032 |