Provider Demographics
NPI:1609866862
Name:YAU, KWONG K (MD)
Entity Type:Individual
Prefix:DR
First Name:KWONG
Middle Name:K
Last Name:YAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KENNENTH
Other - Middle Name:KWONG
Other - Last Name:YAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:200 JOSE FIGUERES AVE
Mailing Address - Street 2:#300
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1585
Mailing Address - Country:US
Mailing Address - Phone:408-254-8828
Mailing Address - Fax:408-254-8848
Practice Address - Street 1:200 JOSE FIGUERES AVE
Practice Address - Street 2:#300
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1585
Practice Address - Country:US
Practice Address - Phone:408-254-8828
Practice Address - Fax:408-254-8848
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2007-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50656208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF45796Medicare UPIN