Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | OT011347 | PA |
Y | 2081P2900X | Pain Medicine | 20A10769 | CA |
NPI | 1023174042 |
---|---|
Provider Name | Dr. Michael T Young |
First Address | Ukiah, CA 95482-2739 |
Second Address | Ukiah, CA 95482-4568 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 11/06/2015 |