Healthcare Provider Details

I. General information

NPI: 1730448101
Provider Name (Legal Business Name): BILL CHOU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 FIRE MESA ST STE 180
LAS VEGAS NV
89128-9017
US

IV. Provider business mailing address

2410 FIRE MESA ST STE 180
LAS VEGAS NV
89128-9017
US

V. Phone/Fax

Practice location:
  • Phone: 702-992-6888
  • Fax: 702-992-6880
Mailing address:
  • Phone: 702-992-6888
  • Fax: 702-992-6880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number14794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: