Healthcare Provider Details

I. General information

NPI: 1538655808
Provider Name (Legal Business Name): DAMIEN ANDREW LEE YOUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 CALIFORNIA AVE STE 460
BAKERSFIELD CA
93309-1698
US

IV. Provider business mailing address

5080 CALIFORNIA AVE STE 460
BAKERSFIELD CA
93309-1698
US

V. Phone/Fax

Practice location:
  • Phone: 855-427-2778
  • Fax:
Mailing address:
  • Phone: 855-427-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA174892
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: