Provider Demographics
NPI:1275512675
Name:YOUNG, ROLANDO C (MD)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:C
Last Name:YOUNG
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 1:1705 28TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1902
Mailing Address - Country:US
Mailing Address - Phone:661-322-4080
Mailing Address - Fax:661-322-5507
Practice Address - Street 1:1705 28TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1902
Practice Address - Country:US
Practice Address - Phone:661-322-4080
Practice Address - Fax:661-322-5507
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC412882084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C412880Medicaid
CA00C412880Medicare ID - Type Unspecified
CA00C412880Medicaid