MEDICARE: DR. JUSTIN C YOUNG 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
1	2084P0800X	Psychiatry Physician	A92560	CA

General Provider Information

NPI Number	:	1437356078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN C YOUNG M.D.

Provider Business Mailing Address
First Line	:	825 OAK GROVE AVE
Second Line	:	SUITE A201
City	:	MENLO PARK
State	:	CA
Zip	:	94025
Country	:	US
Telephone Number	:	650-838-9888
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 OAK GROVE AVE
Second Line	:	SUITE A201
City	:	MENLO PARK
State	:	CA
Zip	:	94025-4434
Country	:	US
Telephone Number	:	650-838-9888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	08/04/2008

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