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NPI Code Detail

MEDICARE: DR. JOHN YOUNGBLOOD M.D.

MEDICARE: DR. JOHN YOUNGBLOOD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianC51762CA

General Provider Information

NPI Number : 1285714782
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN YOUNGBLOOD M.D.
Provider Business Mailing Address
First Line : 11670 ATWOOD RD
Second Line :
City : AUBURN
State : CA
Zip : 95603-9522
Country : US
Telephone Number : 530-887-2810
Fax Number : 530-887-2849
Provider Business Practice Location Address
First Line : 11670 ATWOOD RD
Second Line :
City : AUBURN
State : CA
Zip : 95603-9522
Country : US
Telephone Number : 530-887-2810
Fax Number : 530-887-2849
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JOHN YOUNGBLOOD M.D.” Practice Location

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