Provider Demographics
NPI:1326023482
Name:KEUNG, YI-KONG (MD)
Entity Type:Individual
Prefix:
First Name:YI-KONG
Middle Name:
Last Name:KEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YI
Other - Middle Name:KONG
Other - Last Name:KEUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1411 S GARFIELD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-5024
Mailing Address - Country:US
Mailing Address - Phone:626-588-2825
Mailing Address - Fax:626-588-2850
Practice Address - Street 1:1411 S GARFIELD AVE STE 200
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5024
Practice Address - Country:US
Practice Address - Phone:626-588-2825
Practice Address - Fax:626-588-2850
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53429207RH0003X
NC99-00565207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1802827000Medicaid
NC91604OtherMEDCOST
CAGR0092870Medicaid
CA1326023482Medicaid
7819435OtherAETNA
SCQ0056GMedicaid
VA6003214Medicaid
NC1233GOtherBCBS
NC31638OtherPARTNERS
NC891233GMedicaid
CAGR0092870Medicaid
CABN307YMedicare PIN
NC1233GOtherBCBS
SCQ0056GMedicaid