Healthcare Provider Details

I. General information

NPI: 1275974768
Provider Name (Legal Business Name): KWOK HIN ALEX YUEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 S BASCOM AVE
SAN JOSE CA
95128-2651
US

IV. Provider business mailing address

828 S BASCOM AVE
SAN JOSE CA
95128-2651
US

V. Phone/Fax

Practice location:
  • Phone: 408-793-5959
  • Fax:
Mailing address:
  • Phone: 408-793-5959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: