Individual provider Active NPI

Barry Young, DPM

  • Podiatrist
  • Loma Linda, CA
National Provider Identifier
1093968117
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1961 Issued in CA
Practice address
11332 Mountain View Ave
Suite a
Loma Linda, CA 92354-3854
Phone
(909) 796-3707
Fax
(909) 796-3709
NPI assigned
Nov 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E1961 CA Primary
Primary Podiatric Medicine Podiatrist 213EP1101X E1961 CA

Addresses

Primary practice location

11332 Mountain View Ave
Suite a
Loma Linda, CA 92354-3854

Mailing address

PO Box 1069
Loma Linda, CA 92354-1069
Phone (909) 796-3707

Other identifiers 1

IdentifierTypeStateIssuer
E1961OtherCABOARD OF PODIATRIC MEDICINE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mariam Amiri Podiatrist Past Accepting new patients
Mariam Amiri Past Accepting new patients
James F Eggold Podiatrist PastSince Jan 3, 2010 Accepting new patients
Convalescent Podiatry Care Podiatrist PastSince Jan 3, 2010 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1093968117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1069",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541069",
            "telephone_number": "909-796-3707",
            "fax_number": "909-796-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11332 MOUNTAIN VIEW AVE",
            "address_2": "SUITE A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543854",
            "telephone_number": "909-796-3707",
            "fax_number": "909-796-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BARRY",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E1961",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E1961",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PODIATRIC MEDICINE",
            "identifier": "E1961",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.