Provider Demographics
NPI:1891082368
Name:KO, YEN CHEN KEVIN (MD, DMD)
Entity Type:Individual
Prefix:DR
First Name:YEN CHEN KEVIN
Middle Name:
Last Name:KO
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:LANE 235
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 W 10TH AVE
Practice Address - Street 2:JPPN, 1ST FL, RM 1250
Practice Address - City:VANCOUVER
Practice Address - State:BC
Practice Address - Zip Code:V5Z 1M9
Practice Address - Country:CA
Practice Address - Phone:604-875-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0589451223P0106X
CAA151446207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology