Organization Active NPI

Edward M. Young, Jr., MD Inc.

  • Dermatology Physician
  • Tarzana, CA
National Provider Identifier
1508035338
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
EDWARD M. YOUNG, JR., MD INC.
Practice address
5567 Reseda Blvd Ste 101
Tarzana, CA 91356-2648
Phone
(818) 343-6653
Fax
(818) 343-8863
NPI assigned
Feb 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Edward M Young, M.D.
Title
Owner
Phone
(310) 202-6204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

5567 Reseda Blvd Ste 101
Tarzana, CA 91356-2648

Mailing address

3710 Robertson Blvd Ste 201
Culver City, CA 90232-2347
Phone (310) 202-6204

National Provider Directory

National Provider Directory

Locations

3710 Robertson Blvd
Culver City, CA 90232

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1508035338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 ROBERTSON BLVD STE 201",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322347",
            "telephone_number": "310-202-6204",
            "fax_number": "310-202-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5567 RESEDA BLVD STE 101",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562648",
            "telephone_number": "818-343-6653",
            "fax_number": "818-343-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD M. YOUNG, JR., MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-202-6204",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.