Provider Demographics
NPI:1881762953
Name:DOUGLAS YOUNG, M.D.,INC.
Entity type:Organization
Organization Name:DOUGLAS YOUNG, M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-484-0500
Mailing Address - Street 1:3840 WATT AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-2640
Mailing Address - Country:US
Mailing Address - Phone:916-484-0500
Mailing Address - Fax:916-484-0600
Practice Address - Street 1:3840 WATT AVE
Practice Address - Street 2:SUITE E
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2640
Practice Address - Country:US
Practice Address - Phone:916-484-0500
Practice Address - Fax:916-484-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21878ZMedicare PIN