Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 058945 | NY |
NPI | 1891082368 |
---|---|
Provider Name | Dr. Yen Chen Kevin Ko |
First Address | Stanford, CA 94305-2200 |
Second Address | Vancouver, BC V5Z 1M9 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2011 |
Last Update Date | 09/07/2020 |