Healthcare Provider Details

I. General information

NPI: 1437845666
Provider Name (Legal Business Name): REGINA MICHELLE YOUNG M.B.B.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date: 11/17/2023
Reactivation Date: 02/12/2024

III. Provider practice location address

3800 W 24TH ST
YUMA AZ
85364-9258
US

IV. Provider business mailing address

2400 S AVENUE A
YUMA AZ
85364-7127
US

V. Phone/Fax

Practice location:
  • Phone: 928-344-6450
  • Fax: 928-344-6480
Mailing address:
  • Phone: 928-344-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number79028
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: