Provider Demographics
NPI:1083906309
Name:YOUNG, RAYMOND (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3222 S BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-7683
Mailing Address - Country:US
Mailing Address - Phone:559-627-0312
Mailing Address - Fax:559-635-4147
Practice Address - Street 1:1119 W VISALIA RD
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:CA
Practice Address - Zip Code:93221-2204
Practice Address - Country:US
Practice Address - Phone:559-592-4901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist