MEDICARE: MATTHEW TSAO KIOK

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	2083X0100X	Occupational Medicine Physician	A164749	CA
2	2083X0100X	Occupational Medicine Physician	22128	NV

General Provider Information

NPI Number	:	1184127953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW TSAO KIOK

Provider Business Mailing Address
First Line	:	2810 W CHARLESTON BLVD STE 60
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2810 W CHARLESTON BLVD STE 60
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1906
Country	:	US
Telephone Number	:	702-530-1031
Fax Number	:

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

Provider Enumeration Date	:	03/17/2018
Last Update Date	:	11/16/2022

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