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General NPI Number Information
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NPI Number | 1356469159
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Entity Type | Organization
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Legal Business Name | JOHN K. YOUNG, D.O., INC.
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1230 E CARSON ST
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City | LONG BEACH
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State | CA
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Zip | 90807-3031
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Country | US
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Telephone | 562-424-7723
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Fax | 562-427-4999
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Provider Business Mailing Address
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Address Line | 1230 E CARSON ST
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City | LONG BEACH
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State | CA
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Zip | 90807-3031
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Country | US
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Telephone | 562-424-7723
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Fax | 562-427-4999
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | JOHN K YOUNG
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Credential | D.O.
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Telephone | 562-424-7723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 204969
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License Number State | CA
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