Provider Demographics
NPI:1811144512
Name:YOUNG, MARGARET S (PT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:S
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26585 SOTELO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3341
Mailing Address - Country:US
Mailing Address - Phone:949-582-8676
Mailing Address - Fax:949-582-2672
Practice Address - Street 1:1285 GLENNEYRE ST
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-3102
Practice Address - Country:US
Practice Address - Phone:949-494-2046
Practice Address - Fax:949-494-2043
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT010337225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT010337OtherLICENSE NUMBER