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NPI Code Detail

MEDICARE: MR. CAROL LYNNE YOUNG D.C.

MEDICARE: MR. CAROL LYNNE YOUNG D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NS0005XSports Physician ChiropractorDC22401CA

General Provider Information

NPI Number : 1043218746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CAROL LYNNE YOUNG D.C.
Provider Business Mailing Address
First Line : 5922 WARNER AVE
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92649-4660
Country : US
Telephone Number : 714-377-2257
Fax Number : 714-377-2256
Provider Business Practice Location Address
First Line : 5922 WARNER AVE
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92649-4660
Country : US
Telephone Number : 714-377-2257
Fax Number : 714-377-2256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/08/2007

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