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NPI Code Detail

MEDICARE: DR. DUSTIN ZANE DEYOUNG M.D.

MEDICARE: DR. DUSTIN ZANE DEYOUNG M.D.
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
12084P0800XPsychiatry PhysicianA126902CA
2207Q00000XFamily Medicine PhysicianA126902CA

General Provider Information

NPI Number : 1346403953
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DUSTIN ZANE DEYOUNG M.D.
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6344 TOPANGA CANYON BLVD STE 2040
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-2362
Country : US
Telephone Number : 818-610-0292
Fax Number : 818-610-0293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2008
Last Update Date : 12/02/2019

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Directions to “ DR. DUSTIN ZANE DEYOUNG M.D.” Practice Location

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