Provider Demographics
NPI:1629042437
Name:YOUNG, RICHARD ALAN (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALAN
Last Name:YOUNG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1 BAYWOOD AVE
Mailing Address - Street 2:STE 10
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402
Mailing Address - Country:US
Mailing Address - Phone:650-342-2974
Mailing Address - Fax:650-347-5404
Practice Address - Street 1:1 BAYWOOD AVE
Practice Address - Street 2:STE 10
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402
Practice Address - Country:US
Practice Address - Phone:650-342-2974
Practice Address - Fax:650-347-5404
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2010-01-21
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Provider Licenses
StateLicense IDTaxonomies
CAG53170207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A52461Medicare UPIN