Healthcare Provider Details

I. General information

NPI: 1285957589
Provider Name (Legal Business Name): PATRICIA ANN YOUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BOULEVARD, ROOM 5512
LOS ANGELES CA
90048
US

IV. Provider business mailing address

600 S. DETROIT ST. APT, 213
LOS ANGELES CA
90036
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-5585
  • Fax:
Mailing address:
  • Phone: 310-804-0864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberA115400
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: