TONI ELIZABETH YOUNG-PEN


Address: 4290 Polk Ave, San Diego, CA 92105-1524
Phone: 6195630507

TONI ELIZABETH YOUNG-PEN (NPI# 1932297595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932297595
Entity Type Individual
Full Name TONI ELIZABETH YOUNG-PEN
Credential PAC
Practice Address 4290 Polk Ave
San Diego
CA 92105-1524
Mailing Address 3329 Nutmeg St
San Diego
CA 92104-5250
Practice Telephone 6195630507
Practice Fax Number 6195630015
Mailing Telephone 6198072524
Enumeration Date 2006-10-10
Last Update Date 2017-10-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PA 18746 CA Physician Assistants & Advanced Practice Nursing Providers
N 363A00000X Physician Assistant PA10003685 WA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WA CRIME VICTIMS 8939200 01
WA 8413932 05
WA WORKERS COMPENSATION 149986 01

Office Location

Street Address 4290 POLK AVE
City SAN DIEGO
State CA
Zip Code 92105-1524

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306827332 San Diego Family Care Clinic/Center 4290 Polk Ave, San Diego, CA 92105-1524 2005-11-08
1285277533 Julia Burns Nurse Practitioner 4290 Polk Ave, San Diego, CA 92105-1524 2019-10-18
1700230364 Maria Elena Almirante Podiatrist 4290 Polk Ave, San Diego, CA 92105-1524 2016-04-20
1578865184 Deena Chusid Dietitian, Registered 4290 Polk Ave, San Diego, CA 92105-1524 2010-12-02
1942433917 Nusha Nouhi Psychologist 4290 Polk Ave, San Diego, CA 92105-1524 2009-08-25
1710140462 Gwen Ellen Gleason-rohrer Family Medicine 4290 Polk Ave, San Diego, CA 92105-1524 2008-07-02
1902939630 Christina A Forzani Counselor 4290 Polk Ave, San Diego, CA 92105-1524 2007-03-13
1982746657 Tonnia Thuhanh Tran Family Medicine 4290 Polk Ave, San Diego, CA 92105-1524 2007-02-12
1558442566 Sharmila G Carlton Psychiatry & Neurology 4290 Polk Ave, San Diego Family Care, San Diego, CA 92105-1524 2006-10-17
1164435681 Jennifer Lynn Poast Internal Medicine 4290 Polk Ave, San Diego, CA 92105-1524 2006-08-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851934798 Point Loma Nazarene University Nurse Practitioner Point Loma Nazarene University Health Promotion Center, 4101 University Avenue, San Diego, CA 92105 2019-10-23
1104478809 Kristin Lynn Nichols Counselor 4823 El Cajon Blvd Suite #115, San Diego, CA 92105 2019-07-12
1205343076 Momentum Learning Counselor 3720 El Cajon Blvd., Sd, CA 92105 2018-01-03
1306352695 Nathan Hien Le, Dds. Inc Dentist 4170 Fairmount Ave., San Diego, CA 92105 2017-12-21
1073038071 Aika Mary Erlandson Student in an Organized Health Care Education/Training Program 5296 University Ave. Suite F-2, San Diego, CA 92105 2017-08-10
1457872178 Ride-in Transport LLC Non-emergency Medical Transport (VAN) 4061 Fairmount Ave, San Diego, CA 92105 2017-07-03
1598205346 Ahmed Mooge Ambulance 4061 Fairmout Ave, San Diego, CA 92105 2017-02-27
1083152748 Rady Childrens Hospital-san Diego Psychiatric Unit 4305 University Avenue, Suite 150, San Diego, CA 92105 2017-02-02
1730634098 Med Specialty Sai Inc. Pharmacy 4153 University Avenue, Suite B, San Diego, CA 92105 2016-08-16
1568857464 Dr. Jeffrey A. Saladin, Dental Corporation Dentist 4074 Fairmount Avenue, Suite B, San Diego, CA 92105 2015-03-30
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1083213706 Courtney Kathryn Hopp Physician Assistant 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 2020-10-23
1639776503 Nathan Tuan Dinh Physician Assistant 8296 Via Escalada, San Diego, CA 92129-2223 2020-10-05
1750988671 Denise Aquino Physician Assistant 7322 Mesa College Dr Apt 7, San Diego, CA 92111-4943 2020-10-04
1962009183 Courtney Krysl Physician Assistant 14434 Corte Lampara, San Diego, CA 92129-3818 2020-10-01
1497369284 Brian Carroll Physician Assistant 7242 Melotte St, San Diego, CA 92119-1613 2020-08-31
1871104067 Satoshi Ikeda Physician Assistant 16198 Paseo Del Sur, San Diego, CA 92127-6155 2020-08-12
1760009989 Lili Tran Physician Assistant 8865 Calle Tragar, San Diego, CA 92129-2156 2020-07-03
1245857259 Kendra Roberta Witt Physician Assistant 11396 Poblado Rd, San Diego, CA 92127-1351 2020-06-25
1336766344 Brandon Scott Johnson Physician Assistant 1540 Oliver Ave Apt C, San Diego, CA 92109-5595 2020-06-25
1104441021 Kira Ann Tellache Physician Assistant 4520 Executive Dr Ste 325, San Diego, CA 92121-3087 2020-06-16
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Competitor

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City SAN DIEGO
Zip Code 92105

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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