Provider Demographics
NPI:1013006949
Name:YOUNG, BENITA KHO (MD)
Entity Type:Individual
Prefix:
First Name:BENITA
Middle Name:KHO
Last Name:YOUNG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1505 S SHEPARD DR
Mailing Address - Street 2:STE 103
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454
Mailing Address - Country:US
Mailing Address - Phone:805-922-0439
Mailing Address - Fax:805-922-8219
Practice Address - Street 1:1505 SHEPARD DR
Practice Address - Street 2:STE 103
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-7020
Practice Address - Country:US
Practice Address - Phone:805-922-0439
Practice Address - Fax:805-922-8219
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA357192080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine