Provider Demographics
NPI:1659427243
Name:YOUNG, ROBERT LINDSAY (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LINDSAY
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2773 HARRIS ST STE D
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4866
Mailing Address - Country:US
Mailing Address - Phone:707-443-3354
Mailing Address - Fax:
Practice Address - Street 1:2773 HARRIS ST STE D
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4866
Practice Address - Country:US
Practice Address - Phone:707-443-3354
Practice Address - Fax:707-443-3356
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC193599207RP1001X, 207RC0200X, 207RC0200X
MT100056207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36804738Medicaid
COC300582Medicare PIN
COG70087Medicare UPIN