Provider Demographics
NPI:1811084114
Name:YOUNG, GABRIEL JANG-JYH (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:JANG-JYH
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10011 N FOOTHILL BLVD
Mailing Address - Street 2:SUITE #105
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5649
Mailing Address - Country:US
Mailing Address - Phone:408-366-0600
Mailing Address - Fax:408-366-0609
Practice Address - Street 1:10011 N FOOTHILL BLVD
Practice Address - Street 2:SUITE #105
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-5649
Practice Address - Country:US
Practice Address - Phone:408-366-0600
Practice Address - Fax:408-366-0609
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA042629207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4177426Medicaid
CAA29615Medicare ID - Type Unspecified
CA4177426Medicaid