Young, Thomas R

Young, Thomas R is an individual health care provider with primary practice located at 5555 Reservoir Drive Suite 112, San Diego CA 92120-5195. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Young, Thomas R can be contacted via phone (619) 287-7060.

Contact Information

Primary practice address
5555 Reservoir Drive Suite 112 San Diego CA 92120-5195
Phone: (619) 287-7060
Fax: (619) 287-7078
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X G69189 California

Profile Details

NPI number 1104998194
LBN Legal business name Young, Thomas R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104998194 NPPES
California MEDICAID 00G691891

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