MEDICARE: HOWARD CHUNG

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1053741041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD CHUNG

Provider Business Mailing Address
First Line	:	1008 COUNTRY SKIES AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-5306
Country	:	US
Telephone Number	:	702-337-4949
Fax Number	:

Provider Business Practice Location Address
First Line	:	4310 CAMERON ST
Second Line	:	SUITE 11
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3826
Country	:	US
Telephone Number	:	702-570-5100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2013
Last Update Date	:	11/12/2013

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Directions to “ HOWARD CHUNG ” Practice Location

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