Healthcare Provider Details

I. General information

NPI: 1669232096
Provider Name (Legal Business Name): NGOC LOAN TONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 04/28/2024
Certification Date: 04/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 W SUNSET RD
LAS VEGAS NV
89148-4844
US

IV. Provider business mailing address

8880 W SUNSET RD
LAS VEGAS NV
89148-5004
US

V. Phone/Fax

Practice location:
  • Phone: 702-916-5000
  • Fax:
Mailing address:
  • Phone: 702-476-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number876136
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: