Provider Demographics
NPI:1508118464
Name:YANG, LI-TEN KEN (DOM)
Entity Type:Individual
Prefix:
First Name:LI-TEN
Middle Name:KEN
Last Name:YANG
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11317 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1740
Mailing Address - Country:US
Mailing Address - Phone:913-638-8688
Mailing Address - Fax:
Practice Address - Street 1:11317 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1740
Practice Address - Country:US
Practice Address - Phone:913-638-8688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002014159171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist