MEDICARE: DR. S.ALEX YOUNG MD

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
1	174400000X	Specialist	A34664	CA

General Provider Information

NPI Number	:	1073701777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. S.ALEX YOUNG MD

Provider Business Mailing Address
First Line	:	18804 MADRONE RD
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93638-0320
Country	:	US
Telephone Number	:	559-673-6450
Fax Number	:	559-673-0389

Provider Business Practice Location Address
First Line	:	2339 W CLEVELAND AVE # 103
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93637-8753
Country	:	US
Telephone Number	:	559-673-8055
Fax Number	:	559-673-0389

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	10/09/2007

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