Healthcare Provider Details

I. General information

NPI: 1801583778
Provider Name (Legal Business Name): STEVEN HAOKUN REN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HAOKUN REN

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5844 NW BARRY RD STE 320
KANSAS CITY MO
64154-1421
US

IV. Provider business mailing address

901 E 104TH ST
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 816-468-8632
  • Fax: 816-468-7722
Mailing address:
  • Phone: 816-502-8752
  • Fax: 816-932-9670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2025052006
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: