MEDICARE: DR. MATTHEW NG 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	207Y00000X	Otolaryngology Physician	10050	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
2	CS10995	OTHER	NV	PHARMACY/CDS

General Provider Information

NPI Number	:	1245218858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW NG M.D.

Provider Business Mailing Address
First Line	:	2040 W CHARLESTON BLVD
Second Line	:	#601
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2227
Country	:	US
Telephone Number	:	702-671-2298
Fax Number	:	702-384-7506

Provider Business Practice Location Address
First Line	:	5380 S RAINBOW BLVD
Second Line	:	SUITE 324
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1877
Country	:	US
Telephone Number	:	702-992-6828
Fax Number	:	702-992-6820

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	03/07/2023

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