Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A20724 | CA |
NPI | 1730147489 |
---|---|
Provider Name | Dr. Joseph M Young |
First Address | Sacramento, CA 95823-2634 |
Second Address | Sacramento, CA 95823-2634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 19/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A207240 | (02) | CA |