Young, Polly T

Young, Polly T is an individual health care provider with primary practice located at 3100 Telegraph Ave #2109 East Bay Family Practice Medical Group Inc, Oakland CA 94609-3210. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Young, Polly T can be contacted via phone (510) 645-9900.

Contact Information

Primary practice address
3100 Telegraph Ave #2109 East Bay Family Practice Medical Group Inc Oakland CA 94609-3210
Phone: (510) 645-9900
Fax: (510) 645-9919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G28119 California

Profile Details

NPI number 1245222744
LBN Legal business name Young, Polly T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Jul 8th, 2007 - about 17 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 1245222744 NPPES
California MEDICAID ODG281190

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