Provider Demographics
NPI:1033410303
Name:LUNG, CARMEN YOUNG (CNM)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:YOUNG
Last Name:LUNG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 DELTA LN
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-8209
Mailing Address - Country:US
Mailing Address - Phone:626-254-9356
Mailing Address - Fax:
Practice Address - Street 1:164 DELTA LN
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-8209
Practice Address - Country:US
Practice Address - Phone:626-254-9356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1914183500000X
CA20279363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No183500000XPharmacy Service ProvidersPharmacist