Provider Demographics
NPI:1396810768
Name:YOUNG, SCOTT S (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:S
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 1:1 KAISER PLZ
Mailing Address - Street 2:16TH FLOOR (CMI)
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3610
Mailing Address - Country:US
Mailing Address - Phone:510-267-2949
Mailing Address - Fax:
Practice Address - Street 1:1 KAISER PLZ
Practice Address - Street 2:16TH FLOOR (CMI)
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3610
Practice Address - Country:US
Practice Address - Phone:510-267-2949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine