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NPI Code Detail

MEDICARE: BRUCE H YOUNG LCSW

MEDICARE: BRUCE H YOUNG LCSW
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
11041C0700XClinical Social Worker13066LCSCA

General Provider Information

NPI Number : 1831287556
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE H YOUNG LCSW
Provider Business Mailing Address
First Line : 5838 EDISON PL STE 100
Second Line :
City : CARLSBAD
State : CA
Zip : 92008-5520
Country : US
Telephone Number : 800-275-3243
Fax Number :
Provider Business Practice Location Address
First Line : 4929 WILSHIRE BLVD STE 500
Second Line :
City : LOS ANGELES
State : CA
Zip : 90010-3820
Country : US
Telephone Number : 800-275-3243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 04/08/2021

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