Provider Demographics
NPI:1902860802
Name:GARCIA-YOUNG, JORGE ALEJANDRO III (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ALEJANDRO
Last Name:GARCIA-YOUNG
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:GARCIA-YOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:600 COFFEE RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-4201
Mailing Address - Country:US
Mailing Address - Phone:209-521-6097
Mailing Address - Fax:
Practice Address - Street 1:1700 COFFEE RD
Practice Address - Street 2:DEPARTMENT OF RADIATION ONCOLOGY
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2803
Practice Address - Country:US
Practice Address - Phone:209-572-7237
Practice Address - Fax:209-526-5280
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA916542085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A916540Medicaid
CAGR0078260Medicaid
I36799Medicare UPIN
CA00A916540Medicaid
00A916540Medicare ID - Type UnspecifiedPPIN