Active NPI
Mark Alan Young, P.T.
- Physical Therapist
- Monterey, CA
National Provider Identifier
1376690370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 13274
- Practice address
- 929 Pacific St
Monterey, CA 93940-4447 - Phone
- (831) 373-1209
- Fax
- (831) 373-7102
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 13274 | CA | Primary |
Addresses
Primary practice location
929 Pacific St
Monterey, CA 93940-4447
Mailing address
929 Pacific St
Monterey, CA 93940-4447
Phone (831) 373-1209
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT 13274 | Other | CA | LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13274 | CA | MD | Optometrist |
| PT 13274 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1376690370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 PACIFIC ST",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939404447",
"telephone_number": "831-373-1209",
"fax_number": "831-373-7102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 PACIFIC ST",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939404447",
"telephone_number": "831-373-1209",
"fax_number": "831-373-7102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MARK",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 13274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PT 13274",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monterey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.