Individual provider Active NPI

Jeffrey C Young, D.O.

  • Family Medicine Physician
  • San Gabriel, CA
National Provider Identifier
1376630616
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6648 Issued in CA
Practice address
416 W Las Tunas Dr
Suite 205
San Gabriel, CA 91776-1236
Phone
(626) 571-7958
Fax
(626) 571-7293
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A6648 CA Primary

Addresses

Primary practice location

416 W Las Tunas Dr
Suite 205
San Gabriel, CA 91776-1236

Mailing address

416 W Las Tunas Dr
Suite 205
San Gabriel, CA 91776-1236
Phone (626) 571-7958

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
I20101007000173 CA Practitioner - Family Practice 2668664889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Physicians and Surgeons, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey C Young DO IncGroup PAC ID 1759573975, 2 clinicians

Practice addresses (Care Compare)

416 W Las Tunas Dr
San Gabriel, CA 91776-1236

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6648CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey C. Young, D.O. Inc Family Medicine CurrentSince Jun 27, 2010 Accepting new patients
Alhambra Hospital Medical Center, LP Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients

Locations

600 N Garfield Ave
Ste 107
Monterey Park, CA 91754
Phone (626) 288-8288

416 W Las Tunas Dr
Ste 205
San Gabriel, CA 91776
Phone (626) 571-7958

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1376630616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR",
            "address_2": "SUITE 205",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-571-7958",
            "fax_number": "626-571-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR",
            "address_2": "SUITE 205",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-571-7958",
            "fax_number": "626-571-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.