Individual provider Active NPI

Quinton Tyler Young, D.O.

  • Pediatrics Physician
  • Fresno, CA
National Provider Identifier
1306148879
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A11507 Issued in CA
Practice address
7085 N. Whitney Avenue
Suite #101
Fresno, CA 93720-8002
Phone
(559) 437-7338
NPI assigned
Dec 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20A11507 CA Primary

Addresses

Primary practice location

7085 N. Whitney Avenue
Suite #101
Fresno, CA 93720-8002

Mailing address

PO Box 28949
Fresno, CA 93729-8949
Phone (559) 228-4200

Other practice location 1

155 N Fresno St
Fresno, CA 93701-2302
Phone (559) 499-6400

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
I20120525000544 CA Practitioner - Pediatric Medicine 7416110697 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11507CAMDProfessional Counselor
20A11507CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Jan 1, 2013 Accepting new patients
Community Foundation Medical Group CurrentSince Jan 1, 2013 Accepting new patients
Community Medical Providers Medical Group Inc Past Accepting new patients

Locations

7085 N Whitney Ave
Ste 101
Fresno, CA 93720
Phone (559) 437-7338

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

48677 Victoria Ln
Oakhurst, CA 93644
Phone (559) 683-2711

Organizations & group practices 3

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": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1306148879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28949",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937298949",
            "telephone_number": "559-228-4200",
            "fax_number": "559-224-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7085 N. WHITNEY AVENUE",
            "address_2": "SUITE #101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208002",
            "telephone_number": "559-437-7338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 N Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937012302",
            "country_code": "US",
            "telephone_number": "559-499-6400",
            "fax_number": "559-499-6411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "QUINTON",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-03",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A11507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.