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NPI Code Detail

MEDICARE: HUY THANHTUAN LY MD

MEDICARE: HUY THANHTUAN LY MD
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
1207R00000XInternal Medicine Physician11113NV

Other Identifiers

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

General Provider Information

NPI Number : 1679547525
Entity Type Code : Individual
Provider Name (Legal Business Name) : HUY THANHTUAN LY MD
Provider Business Mailing Address
First Line : 5400 S RAINBOW BLVD
Second Line : SOUND PHYSICIANS
City : LAS VEGAS
State : NV
Zip : 89128
Country : US
Telephone Number : 702-305-2408
Fax Number : 702-853-3245
Provider Business Practice Location Address
First Line : 5400 S RAINBOW BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1859
Country : US
Telephone Number : 702-305-2408
Fax Number : 702-853-3245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2006
Last Update Date : 09/06/2012

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Directions to “ HUY THANHTUAN LY MD” Practice Location

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