MEDICARE: JOSEPH K. ENG O.D.

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	152W00000X	Optometrist	461	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	:	1063581056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH K. ENG O.D.

Provider Business Mailing Address
First Line	:	6005 S EASTERN AVE
Second Line	:	SUITE #100
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3135
Country	:	US
Telephone Number	:	702-435-8448
Fax Number	:	702-435-8438

Provider Business Practice Location Address
First Line	:	6005 S EASTERN AVE
Second Line	:	SUITE #100
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3135
Country	:	US
Telephone Number	:	702-435-8448
Fax Number	:	702-435-8438

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	10/15/2008

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