Healthcare Provider Details

I. General information

NPI: 1740807783
Provider Name (Legal Business Name): KATHERINE E YOUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 VETERANS BLVD
REDWOOD CITY CA
94063-2037
US

IV. Provider business mailing address

1190 VETERANS BLVD
REDWOOD CITY CA
94063-2037
US

V. Phone/Fax

Practice location:
  • Phone: 650-299-2015
  • Fax: 650-299-2727
Mailing address:
  • Phone: 650-299-2015
  • Fax: 650-299-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA186784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: