Healthcare Provider Details

I. General information

NPI: 1134840580
Provider Name (Legal Business Name): CLAIRE CHO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2022
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SHADOW LN
LAS VEGAS NV
89106-4119
US

IV. Provider business mailing address

10624 S EASTERN AVE # A-955
HENDERSON NV
89052-2982
US

V. Phone/Fax

Practice location:
  • Phone: 702-388-8436
  • Fax:
Mailing address:
  • Phone: 702-407-7700
  • Fax: 702-407-7016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO4089
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: