Provider Demographics
NPI:1922580562
Name:YOUNG, BRYAN JOSEPH (MSN FNP-C)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:JOSEPH
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 A ST # 28354
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-4003
Mailing Address - Country:US
Mailing Address - Phone:888-705-8722
Mailing Address - Fax:888-705-8722
Practice Address - Street 1:39950 VISTA DEL SOL
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3206
Practice Address - Country:US
Practice Address - Phone:760-340-0053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009457363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner