Provider Demographics
NPI:1548263890
Name:KHO, YUNG (MD)
Entity type:Individual
Prefix:DR
First Name:YUNG
Middle Name:
Last Name:KHO
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 1:1601 NE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1035
Mailing Address - Country:US
Mailing Address - Phone:541-474-5071
Mailing Address - Fax:541-476-0866
Practice Address - Street 1:1601 NE 6TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1035
Practice Address - Country:US
Practice Address - Phone:541-474-5071
Practice Address - Fax:541-476-0866
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD249122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR229260Medicaid
ORA26537Medicare UPIN
ORR110153Medicare PIN