Provider Demographics
NPI:1710217229
Name:YOUNG, DAVID VAUGHN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:VAUGHN
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3161 CAMERON PARK DR STE 104
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-7977
Mailing Address - Country:US
Mailing Address - Phone:530-676-9300
Mailing Address - Fax:530-676-1783
Practice Address - Street 1:3161 CAMERON PARK DR STE 104
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7977
Practice Address - Country:US
Practice Address - Phone:530-676-9300
Practice Address - Fax:530-676-1783
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor