Individual
KENNETH YAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
90 BERGEN ST STE 8100, NEWARK, NJ 07103-2425
(973) 972-4588
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
125068441
IL
207Y00000X
Otolaryngology Physician
Primary
25MA11464200
NJ
207Y00000X
Otolaryngology Physician
A171225
CA
Other
Enumeration date
05/16/2016
Last updated
08/22/2023
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