Provider Demographics
NPI:1104019421
Name:YOUNGWORTH, HOWARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:J
Last Name:YOUNGWORTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 SHASTA ST
Mailing Address - Street 2:SUTTER BUTTES IMAGING MEDICAL GROUP, INC
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-4114
Mailing Address - Country:US
Mailing Address - Phone:530-674-9000
Mailing Address - Fax:
Practice Address - Street 1:945 SHASTA ST
Practice Address - Street 2:SUTTER BUTTES IMAGING MEDICAL GROUP, INC
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4114
Practice Address - Country:US
Practice Address - Phone:530-674-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA964492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology