Keith William Young, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A053063 Issued in CA

Practice address

10780 Santa Monica Blvd
Suite 250
Los Angeles, CA 90025-4749

Phone

(310) 475-7911

Fax

(310) 475-1669

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 8, 2012 through Dec 8, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jacob Moussai MD Inc

  • Psychiatry Physician
  • Beverly Hills, CA
  • NPI 1750622585
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821125071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10780 SANTA MONICA BLVD",
            "address_2": "SUITE 250",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254749",
            "telephone_number": "310-475-7911",
            "fax_number": "310-475-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10780 SANTA MONICA BLVD",
            "address_2": "SUITE 250",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254749",
            "telephone_number": "310-475-7911",
            "fax_number": "310-475-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KEITH",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A053063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Young, R.PH.
• Joy Young, MS, CCC-SLP
• Justin Young
• Katelyn Young, CRNA
• Katie Lynn Young, MD
• Kevin Young, MD
• Lance Young, FNP-BC, NP-C
• Leah Patrice Young
• Leslie Young
• Lorraine Clarke Young, MD

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.