Healthcare Provider Details

I. General information

NPI: 1922504042
Provider Name (Legal Business Name): CHIEN-YEU CHUN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 PINTO LN STE 200
LAS VEGAS NV
89106-4007
US

IV. Provider business mailing address

2011 PINTO LN STE 200
LAS VEGAS NV
89106-4007
US

V. Phone/Fax

Practice location:
  • Phone: 702-382-3200
  • Fax: 702-382-3575
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number22558
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberNVPENDING
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: