Individual provider Active NPI

Kevin R Young

  • Pharmacist
  • Buena Park, CA
National Provider Identifier
1609489053
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
82973 Issued in CA
Practice address
7065 La Palma Ave
Buena Park, CA 90620-2424
Phone
(714) 228-2085
NPI assigned
Aug 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 82973 CA Primary

Addresses

Primary practice location

7065 La Palma Ave
Buena Park, CA 90620-2424

Mailing address

7065 La Palma Ave
Buena Park, CA 90620-2424
Phone (714) 228-2085

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

LicenseStateTypeSpecialty
82973CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS LLC PastSince Aug 30, 2020 Accepting new patients
Garfield Beach CVS, L.L.C. PastSince Aug 30, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1609489053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7065 LA PALMA AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906202424",
            "telephone_number": "714-228-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7065 LA PALMA AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906202424",
            "telephone_number": "714-228-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KEVIN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "82973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.