Individual provider Active NPI

Young DO Jeong, MD

  • Public Health & General Preventive Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1447889670
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
A201815 Issued in CA
Practice address
11441 Heacock St Ste F
Moreno Valley, CA 92557-7907
Phone
(951) 243-8000
Fax
(951) 243-9707
NPI assigned
Apr 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Public Health & General Preventive Medicine Physician 2083P0901X A201815 CA Primary

Addresses

Primary practice location

11441 Heacock St Ste F
Moreno Valley, CA 92557-7907

Mailing address

11441 Heacock St Ste F
Moreno Valley, CA 92557-7907
Phone (951) 243-8000

Other practice location 1

3975 Jackson St Ste 101
Riverside, CA 92503-3938
Phone (951) 243-8000

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A201815CAMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1447889670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11441 HEACOCK ST STE F",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577907",
            "telephone_number": "951-243-8000",
            "fax_number": "951-243-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11441 HEACOCK ST STE F",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577907",
            "telephone_number": "951-243-8000",
            "fax_number": "951-243-9707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3975 Jackson St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033938",
            "country_code": "US",
            "telephone_number": "951-243-8000",
            "fax_number": "951-688-3436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEONG",
        "first_name": "YOUNG DO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "A201815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.