Provider Demographics
NPI:1275972812
Name:LYNUM-YOUNG, WILLIAM LYN (CRT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LYN
Last Name:LYNUM-YOUNG
Suffix:
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 REES RD
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-2115
Mailing Address - Country:US
Mailing Address - Phone:760-644-0120
Mailing Address - Fax:
Practice Address - Street 1:1202 REES RD
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-2115
Practice Address - Country:US
Practice Address - Phone:760-644-0120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33843227800000X
TX76392227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified