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NPI Code Detail

MEDICARE: YEN CHU CHEN OD

MEDICARE:   YEN CHU  CHEN  OD
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
1152W00000XOptometrist1064NV

General Provider Information

NPI Number : 1215545330
Entity Type Code : Individual
Provider Name (Legal Business Name) : YEN CHU CHEN OD
Provider Business Mailing Address
First Line : 6355 S DURANGO DR UNIT 1265
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1878
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6160 W TROPICANA AVE STE E4
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4696
Country : US
Telephone Number : 702-452-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2020
Last Update Date : 11/10/2020

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Directions to “ YEN CHU CHEN OD” Practice Location

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