MEDICARE: DR. YUNG KHO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	MD24912	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548263890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YUNG KHO M.D.

Provider Business Mailing Address
First Line	:	1601 NE 6TH ST
Second Line	:
City	:	GRANTS PASS
State	:	OR
Zip	:	97526-1035
Country	:	US
Telephone Number	:	541-474-5071
Fax Number	:	541-476-0866

Provider Business Practice Location Address
First Line	:	1601 NE 6TH ST
Second Line	:
City	:	GRANTS PASS
State	:	OR
Zip	:	97526-1035
Country	:	US
Telephone Number	:	541-474-5071
Fax Number	:	541-476-0866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/23/2010

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