Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 20279 | CA |
NPI | 1033410303 |
---|---|
Provider Name | Carmen Young Lung |
First Address | Arcadia, CA 91007-8209 |
Second Address | Arcadia, CA 91007-8209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2010 |
Last Update Date | 06/12/2021 |