Individual
STEPHEN GRANVILLE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA, #365,530,420,120, LOS ANGELES, CA 90095-3075
(310) 825-4997
(310) 206-0865
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 825-4934
(310) 206-0865
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G41166
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G411660
—
CA
Enumeration date
07/20/2006
Last updated
06/15/2010
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