Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A93568 | CA |
NPI | 1093904997 |
---|---|
Provider Name | Maile Ann Young |
First Address | La Jolla, CA 92093-5004 |
Second Address | La Jolla, CA 92093-5004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2007 |
Last Update Date | 22/06/2010 |