MEDICARE: DR. EELING ELAINE GOH 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	12747 T	CA
2	152W00000X	Optometrist	660	NV

General Provider Information

NPI Number	:	1083817431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EELING ELAINE GOH O.D.

Provider Business Mailing Address
First Line	:	2016 HUMBLE HOLLOW PL
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89084-3164
Country	:	US
Telephone Number	:	702-546-8988
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 E DEER SPRINGS WAY
Second Line	:	STE 140
City	:	N LAS VEGAS
State	:	NV
Zip	:	89086-1512
Country	:	US
Telephone Number	:	702-651-2000
Fax Number	:

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

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	08/03/2013

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