MEDICARE: DR. KA YAN CHEUNG 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	678	NV

General Provider Information

NPI Number	:	1407160906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KA YAN CHEUNG O.D.

Provider Business Mailing Address
First Line	:	2580 S DECATUR BLVD
Second Line	:	#6
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0050
Country	:	US
Telephone Number	:	702-876-2020
Fax Number	:	702-876-0005

Provider Business Practice Location Address
First Line	:	2580 S DECATUR BLVD
Second Line	:	#6
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0050
Country	:	US
Telephone Number	:	702-876-2020
Fax Number	:	702-876-0005

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

Provider Enumeration Date	:	07/27/2010
Last Update Date	:	05/13/2020

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