Healthcare Provider Details

I. General information

NPI: 1265829345
Provider Name (Legal Business Name): CHRIS YANG WU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6980 SMOKE RANCH RD STE 110
LAS VEGAS NV
89128-8606
US

IV. Provider business mailing address

6980 SMOKE RANCH RD STE 110
LAS VEGAS NV
89128-8606
US

V. Phone/Fax

Practice location:
  • Phone: 702-732-4500
  • Fax: 702-818-1393
Mailing address:
  • Phone: 702-732-4500
  • Fax: 702-818-1393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA161633
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25670
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberA161633
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number25670
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: