Healthcare Provider Details

I. General information

NPI: 1285616680
Provider Name (Legal Business Name): JOSEPH NILAS YOUNG JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2005
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BOULEVARD
SACRAMENTO CA
95817
US

IV. Provider business mailing address

2221 STOCKTON BOULEVARD CYPRESS BUILDING, SUITE 2112
SACRAMENTO CA
95817
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7255
  • Fax: 916-734-3066
Mailing address:
  • Phone: 916-734-7255
  • Fax: 916-734-3066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberC33793
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: