Provider Demographics
NPI:1902901234
Name:YOUNG, DANIELLE Z (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:Z
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18205 N. 51ST AVENUE, BLDG 2
Mailing Address - Street 2:SUITE 109
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1491
Mailing Address - Country:US
Mailing Address - Phone:602-547-1400
Mailing Address - Fax:
Practice Address - Street 1:18205 N. 51ST AVENUE , BLDG. 2
Practice Address - Street 2:SUITE 109
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1491
Practice Address - Country:US
Practice Address - Phone:602-547-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4671207L00000X
AZ36544207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8V3697OtherBCBS PROV ID
TXP00394520OtherRAILROAD MEDICARE
TX198251401Medicaid
TX8V3697OtherBCBS PROV ID
AZ116866Medicare PIN