Healthcare Provider Details

I. General information

NPI: 1700202512
Provider Name (Legal Business Name): JARED YOUNG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20922 SAILMAKER CIR
HUNTINGTON BEACH CA
92648-5272
US

IV. Provider business mailing address

20922 SAILMAKER CIR
HUNTINGTON BEACH CA
92648-5272
US

V. Phone/Fax

Practice location:
  • Phone: 714-591-3601
  • Fax:
Mailing address:
  • Phone: 714-591-3601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number32893
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: