Individual
DR. TIMOTHY YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 EMERSON ST, STE A, CLEARLAKE, CA 95422-9529
(707) 995-4155
(707) 995-4158
Mailing address
3400 EMERSON ST, STE A, CLEARLAKE, CA 95422-9529
(707) 995-4155
(707) 995-4158
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A41608
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A416080
—
CA
01
—
080005029
MEDICARE RAILROAD #
—
Enumeration date
07/07/2005
Last updated
04/17/2009
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