Individual provider Active NPI

Victoria K Young, MD

  • Obstetrics & Gynecology Physician
  • San Diego, CA
National Provider Identifier
1275554941
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD428298 Issued in PA
Practice address
11939 Rancho Bernardo Rd Ste 110
San Diego, CA 92128-2074
Phone
(858) 618-1156
Fax
(858) 618-3314
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD428298 PA Primary

Addresses

Primary practice location

11939 Rancho Bernardo Rd Ste 110
San Diego, CA 92128-2074

Mailing address

11939 Rancho Bernardo Rd Ste 110
San Diego, CA 92128-2074
Phone (858) 618-1156

Other identifiers 1

IdentifierTypeStateIssuer
1016748820001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120710000734 CA Practitioner - Obstetrics/Gynecology 2365547700 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Scripps Health Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 10, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 10, 2024 Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

11939 Rancho Bernardo Rd
Ste 110
San Diego, CA 92128
Phone (858) 613-8949

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

11939 Rancho Bernardo Rd
San Diego, CA 92128
Phone (619) 674-2365

Interoperability endpoints

  • Direct secure messaging: vicki.young.1@10944.direct.athenahealth.com
  • Direct secure messaging: vyoung319957@scrippshlth.medalliesdirect.net

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1275554941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11939 RANCHO BERNARDO RD STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282074",
            "telephone_number": "858-618-1156",
            "fax_number": "858-618-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11939 RANCHO BERNARDO RD STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282074",
            "telephone_number": "858-618-1156",
            "fax_number": "858-618-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "VICTORIA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD428298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016748820001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.