Individual provider Active NPI

Rosabel R Young, M.D., M.S. PHARM.

  • Clinical Neurophysiology Physician
  • Redlands, CA
National Provider Identifier
1659487817
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
G64157 Issued in CA
Practice address
16 E Fern Ave Ste D
Redlands, CA 92373
Phone
(310) 680-0304
Fax
(310) 680-0305
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Physician 202C00000X 988230 CA
Neurology Physician 2084N0400X G64157 CA
Clinical Neurophysiology Physician 2084N0600X 762 IL
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 037607 IL
Clinical Pharmacology Physician 208U00000X G64157 CA
Legal Medicine (M.D./D.O.) Physician 209800000X 988230 CA
Clinical Neurophysiology Physician 2084N0600X G64157 CA Primary

Addresses

Primary practice location

16 E Fern Ave Ste D
Redlands, CA 92373

Mailing address

PO Box 9536
Redlands, CA 92375-2736
Phone (909) 557-8727

Other identifiers 4

IdentifierTypeStateIssuer
00G641570OtherCABLUE SHIELD
180519600OtherCAOWCP
P00011946OtherCARAILROAD MEDICARE
00G641570MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040213000436 CA Practitioner - NeurologyPractitioner - Neuropsychiatry 0941194484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
762ILMDClinical Neurophysiology Physician
037607ILMDSleep Medicine (Psychiatry & Neurology) Physician
988230CAMDLegal Medicine (M.D./D.O.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Neuromedical Services, Inc. Neurology Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1659487817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9536",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923752736",
            "telephone_number": "909-557-8727",
            "fax_number": "909-335-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E FERN AVE STE D",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "310-680-0304",
            "fax_number": "310-680-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ROSABEL",
        "middle_name": "R",
        "credential": "M.D., M.S. PHARM.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "CA",
            "license": "988230",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G64157",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IL",
            "license": "762",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "IL",
            "license": "037607",
            "primary": false
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "CA",
            "license": "G64157",
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "988230",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "G64157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G641570",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "180519600",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00011946",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G641570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.