MEDICARE: SANG YIM

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
1	163W00000X	Registered Nurse	884364	NV

General Provider Information

NPI Number	:	1689481251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANG YIM

Provider Business Mailing Address
First Line	:	8463 GREEN ALDER CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3679
Country	:	US
Telephone Number	:	702-245-8964
Fax Number	:

Provider Business Practice Location Address
First Line	:	8463 GREEN ALDER CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3679
Country	:	US
Telephone Number	:	702-245-8964
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	12/16/2024

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Directions to “ SANG YIM ” Practice Location

Language	Start Address	Practice Location

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