Provider Demographics
NPI:1124298906
Name:YOUNG, CASPER CHARLES (DO)
Entity type:Individual
Prefix:DR
First Name:CASPER
Middle Name:CHARLES
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20750 VENTURA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-6235
Mailing Address - Country:US
Mailing Address - Phone:310-477-8051
Mailing Address - Fax:310-843-9662
Practice Address - Street 1:5400 BALBOA BLVD STE 111
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5206
Practice Address - Country:US
Practice Address - Phone:818-784-8975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9358207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAT587Medicare PIN