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NPI Code Detail

MEDICARE: JEFFREY Y RYU M.D.

MEDICARE: JEFFREY Y RYU 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
1207RN0300XNephrology Physician11350NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427039932
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY Y RYU M.D.
Provider Business Mailing Address
First Line : 2545 S BRUCE ST STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-1778
Country : US
Telephone Number : 702-732-2438
Fax Number : 702-737-5043
Provider Business Practice Location Address
First Line : 2450 FIRE MESA ST STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-9034
Country : US
Telephone Number : 702-853-0090
Fax Number : 702-853-0096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 05/16/2024

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Directions to “ JEFFREY Y RYU M.D.” Practice Location

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