Provider Demographics
NPI:1306388111
Name:YOUNG, JAMES R (PHARM D)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 HEALTH CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2762
Mailing Address - Country:US
Mailing Address - Phone:858-939-6540
Mailing Address - Fax:858-874-2359
Practice Address - Street 1:2929 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2762
Practice Address - Country:US
Practice Address - Phone:858-939-6541
Practice Address - Fax:858-874-2359
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist