Active NPI
Edward Young
- Specialist
- Walnut, CA
National Provider Identifier
1568900447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 10094
- Practice address
- 981 Pebble Creek LN
Walnut, CA 91789-4159 - Phone
- (626) 833-2604
- NPI assigned
- Feb 10, 2017
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 10094 | CA | Primary |
Addresses
Primary practice location
981 Pebble Creek LN
Walnut, CA 91789-4159
Mailing address
981 Pebble Creek LN
Walnut, CA 91789-4159
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10094 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486684800000",
"number": "1568900447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "981 PEBBLE CREEK LN",
"city": "WALNUT",
"state": "CA",
"postal_code": "917894159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "981 PEBBLE CREEK LN",
"city": "WALNUT",
"state": "CA",
"postal_code": "917894159",
"telephone_number": "626-833-2604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "EDWARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-10",
"last_updated": "2017-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "10094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.