Provider Demographics
NPI:1730147489
Name:YOUNG, JOSEPH M (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:M
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, MS
Mailing Address - Street 1:5525 ASSEMBLY CT STE A
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2634
Mailing Address - Country:US
Mailing Address - Phone:916-428-2330
Mailing Address - Fax:916-428-2331
Practice Address - Street 1:5525 ASSEMBLY CT STE A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2634
Practice Address - Country:US
Practice Address - Phone:916-428-2330
Practice Address - Fax:916-428-2331
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA20724207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA22298Medicare PIN
CA00A207240Medicare UPIN