Provider Demographics
NPI:1538655808
Name:LEE YOUNG, DAMIEN ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:DAMIEN
Middle Name:ANDREW
Last Name:LEE 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 1:5080 CALIFORNIA AVE STE 460
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1698
Mailing Address - Country:US
Mailing Address - Phone:855-427-2778
Mailing Address - Fax:
Practice Address - Street 1:5080 CALIFORNIA AVE STE 460
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1698
Practice Address - Country:US
Practice Address - Phone:855-427-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1748922084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry