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NPI Code Detail

MEDICARE: BENNYSON YOUNG SO MD

MEDICARE: BENNYSON YOUNG SO 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
1207R00000XInternal Medicine Physician129351CA
2207RP1001XPulmonary Disease Physician129351CA
3207RC0200XCritical Care Medicine (Internal Medicine) Physician129351CA

General Provider Information

NPI Number : 1407015290
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENNYSON YOUNG SO MD
Provider Business Mailing Address
First Line : 1809 CRYSTAL VIEW CIR
Second Line :
City : NEWBURY PARK
State : CA
Zip : 91320-4596
Country : US
Telephone Number : 914-434-6711
Fax Number :
Provider Business Practice Location Address
First Line : 1910 OUTLET CENTER DR
Second Line :
City : OXNARD
State : CA
Zip : 93036-0677
Country : US
Telephone Number : 805-988-7004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2008
Last Update Date : 02/05/2021

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