Provider Demographics
NPI:1902996077
Name:YEN, HUNG-CHOU (MD)
Entity Type:Individual
Prefix:DR
First Name:HUNG-CHOU
Middle Name:
Last Name:YEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 S AZUSA AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-6813
Mailing Address - Country:US
Mailing Address - Phone:626-964-2660
Mailing Address - Fax:626-964-5757
Practice Address - Street 1:1850 S AZUSA AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-6813
Practice Address - Country:US
Practice Address - Phone:626-964-2660
Practice Address - Fax:626-964-5757
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44606174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A446063Medicaid
CA00A446062Medicaid
CAA44606AMedicare PIN
CA00A446063Medicaid