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General NPI Number Information
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NPI Number | 1316963192
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Entity Type | Organization
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Legal Business Name | TIMOTHY M YOUNG M D INC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 9190 HAVEN AVE SUITE 240
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5431
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Country | US
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Telephone | 909-484-8661
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Fax | 949-588-2199
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Provider Business Mailing Address
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Address Line | 5 HOLLAND SUITE 101
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City | IRVINE
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State | CA
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Zip | 92618-2566
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Country | US
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Telephone | 949-588-2190
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Fax | 949-588-2199
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY M YOUNG
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Credential | M.D.
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Telephone | 949-588-2190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A85891
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License Number State | CA
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