Provider Demographics
NPI:1093924052
Name:YOUNG-TRIPP, SAWAR CHALUTCH (MD)
Entity Type:Individual
Prefix:DR
First Name:SAWAR
Middle Name:CHALUTCH
Last Name:YOUNG-TRIPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAWAR
Other - Middle Name:CHALUTCH
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:CA
Mailing Address - Zip Code:95556-0249
Mailing Address - Country:US
Mailing Address - Phone:530-627-3452
Mailing Address - Fax:530-627-3445
Practice Address - Street 1:1600 WEEOT WAY
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-4734
Practice Address - Country:US
Practice Address - Phone:707-825-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155890207Q00000X
ORMD150077207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine