MEDICARE: PAUL P CHAO PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	5611	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003143603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL P CHAO PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	2860 E DESERT INN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3605
Country	:	US
Telephone Number	:	702-796-9997
Fax Number	:	702-796-1440

Provider Business Practice Location Address
First Line	:	2860 E DESERT INN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3605
Country	:	US
Telephone Number	:	702-796-9997
Fax Number	:	702-796-1440

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL CHAO
Credential	:	M.D.
Telephone Number	:	702-796-9997

Provider Enumeration Date	:	11/03/2009
Last Update Date	:	11/03/2009

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Directions to “PAUL P CHAO PROFESSIONAL CORPORATION ” Practice Location

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