Healthcare Provider Details

I. General information

NPI: 1659487817
Provider Name (Legal Business Name): ROSABEL R YOUNG M.D., M.S. PHARM.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 E FERN AVE STE D
REDLANDS CA
92373
US

IV. Provider business mailing address

PO BOX 9536
REDLANDS CA
92375-2736
US

V. Phone/Fax

Practice location:
  • Phone: 310-680-0304
  • Fax: 310-680-0305
Mailing address:
  • Phone: 909-557-8727
  • Fax: 909-335-8514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number988230
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG64157
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number762
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number037607
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code208U00000X
TaxonomyClinical Pharmacology Physician
License NumberG64157
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code209800000X
TaxonomyLegal Medicine (M.D./D.O.) Physician
License Number988230
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberG64157
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: