Provider Demographics
NPI:1811176647
Name:YOUNG, ALAN S (MD/MBA)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:S
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD/MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WILSHIRE BLVD APT 3404
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1956
Mailing Address - Country:US
Mailing Address - Phone:310-880-1858
Mailing Address - Fax:
Practice Address - Street 1:1100 WILSHIRE BLVD APT 3404
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1956
Practice Address - Country:US
Practice Address - Phone:310-880-1858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100920207X00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery