Provider Demographics
NPI:1235178310
Name:YOUNG, ELLEN C (MD)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:C
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:6401 TRUXTUN AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0613
Mailing Address - Country:US
Mailing Address - Phone:661-323-5300
Mailing Address - Fax:661-631-2210
Practice Address - Street 1:420 34TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2237
Practice Address - Country:US
Practice Address - Phone:661-327-5350
Practice Address - Fax:661-631-2210
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA92690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH75333Medicare UPIN