MEDICARE: DR. CANDICE H TUNG M.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	207R00000X	Internal Medicine Physician	9355	NV

General Provider Information

NPI Number	:	1063598183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CANDICE H TUNG M.D.

Provider Business Mailing Address
First Line	:	12 SANKATY CIR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-6670
Country	:	US
Telephone Number	:	702-838-5248
Fax Number	:	702-838-5248

Provider Business Practice Location Address
First Line	:	7395 S PECOS RD STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3768
Country	:	US
Telephone Number	:	702-737-8657
Fax Number	:	702-737-5446

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

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	02/05/2018

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