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NPI 1659618189

NPI 1659618189 : ARTHUR S TAYENGCO, MD CHARTERED : LAS VEGAS, NV

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General NPI Number Information
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    NPI Number           |    1659618189
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    Entity Type          |    Organization 
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    Legal Business Name  |    ARTHUR S TAYENGCO, MD CHARTERED 
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Dates
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    Enumeration Date     |    01/03/2013
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    Last Update Date     |    01/03/2013
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Provider Practice Location Address
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    Address Line         |    3515 W CHARLESTON BLVD 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89102-1839
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    Country              |    US
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    Telephone            |    702-382-1033
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    Fax                  |    702-382-9507
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Provider Business Mailing Address
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    Address Line         |    3515 W CHARLESTON BLVD 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89102-1839
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    Country              |    US
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    Telephone            |    702-382-1033
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    Fax                  |    702-382-9507
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. ARTHUR S TAYENGCO 
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    Credential           |    M.D.
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    Telephone            |    702-382-1033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261Q00000X
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    Taxonomy Name        |    Clinic/Center
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    License Number       |    2688
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    License Number State |    NV
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