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NPI Code Detail

MEDICARE: DR. JIMMY CHIHHONG WANG M.D.

MEDICARE: DR. JIMMY CHIHHONG WANG 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
12085R0202XDiagnostic Radiology PhysicianA110883CA
22085R0202XDiagnostic Radiology Physician14609NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P001148261OTHERNVRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01285910OTHERCARR DRS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578764593
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JIMMY CHIHHONG WANG M.D.
Provider Business Mailing Address
First Line : 2020 PALOMINO LN
Second Line : #100
City : LAS VEGAS
State : NV
Zip : 89106-4842
Country : US
Telephone Number : 702-759-8600
Fax Number : 702-384-1815
Provider Business Practice Location Address
First Line : 2020 PALOMINO LN
Second Line : #100
City : LAS VEGAS
State : NV
Zip : 89106-4842
Country : US
Telephone Number : 702-759-8600
Fax Number : 702-384-1815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2007
Last Update Date : 11/05/2014

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