Provider Demographics
NPI:1356528632
Name:YOUNG, ARLAN W (DC)
Entity type:Individual
Prefix:DR
First Name:ARLAN
Middle Name:W
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BRITTAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3931
Mailing Address - Country:US
Mailing Address - Phone:650-591-1002
Mailing Address - Fax:650-596-9406
Practice Address - Street 1:1200 BRITTAN AVE
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3931
Practice Address - Country:US
Practice Address - Phone:650-591-1002
Practice Address - Fax:650-596-9406
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13720111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0137200Medicare PIN