Provider Demographics
NPI:1306933973
Name:YOUNG, CARY L (MD)
Entity type:Individual
Prefix:
First Name:CARY
Middle Name:L
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 1:120 ARBUELO WAY
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1748
Mailing Address - Country:US
Mailing Address - Phone:650-949-4019
Mailing Address - Fax:
Practice Address - Street 1:192 BEACON ST
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-6913
Practice Address - Country:US
Practice Address - Phone:650-589-6500
Practice Address - Fax:650-589-7256
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC369742083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C369740Medicare ID - Type Unspecified
CAF35547Medicare UPIN