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General NPI Number Information
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NPI Number | 1912312448
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Entity Type | Organization
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Legal Business Name | JEFFREY L. YOUNG, MD, INC
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 11/13/2015
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Provider Practice Location Address
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Address Line | 5525 ASSEMBLY CT STE A
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City | SACRAMENTO
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State | CA
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Zip | 95823-2634
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Country | US
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Telephone | 916-428-2330
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Fax |
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Provider Business Mailing Address
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Address Line | 5525 ASSEMBLY CT STE A
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City | SACRAMENTO
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State | CA
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Zip | 95823-2634
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Country | US
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Telephone | 916-428-2330
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JEFFREY YOUNG
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Credential | M.D.
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Telephone | 916-428-2330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A061211
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License Number State | CA
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