Provider Demographics
NPI:1659455103
Name:YOUNG, STEVEN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1450 TREAT BLVD # 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2168
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:
Practice Address - Street 1:130 LA CASA VIA
Practice Address - Street 2:BUILDING 3, SUITE 211
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3045
Practice Address - Country:US
Practice Address - Phone:925-933-0984
Practice Address - Fax:925-933-0986
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91467174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI43475Medicare UPIN