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General NPI Number Information
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NPI Number | 1962649483
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Entity Type | Individual
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Provider Name | ROBERT R YOUNG MD
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Gender | Male
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 17260 BEAR VALLEY RD SUITE 109
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City | VICTORVILLE
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State | CA
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Zip | 92395-7777
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Country | US
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Telephone | 760-843-2900
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Fax | 760-843-0144
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Provider Business Mailing Address
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Address Line | 17260 BEAR VALLEY RD SUITE 109
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City | VICTORVILLE
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State | CA
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Zip | 92395-7777
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Country | US
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Telephone | 760-843-2900
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Fax | 760-843-0144
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C26760
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C26760
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License Number State | CA
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