MEDICARE: DR. FUN CHI TU MD

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	207R00000X	Internal Medicine Physician	A118249	CA
2	208M00000X	Hospitalist Physician	14948	NV
3	207R00000X	Internal Medicine Physician	14948	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	14948	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1497927610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FUN CHI TU MD

Provider Business Mailing Address
First Line	:	6625 W SAHARA AVE STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0856
Country	:	US
Telephone Number	:	725-202-3439
Fax Number	:	725-214-4636

Provider Business Practice Location Address
First Line	:	6625 W SAHARA AVE STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0856
Country	:	US
Telephone Number	:	725-202-3439
Fax Number	:	725-214-4636

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

Provider Enumeration Date	:	03/27/2008
Last Update Date	:	12/05/2022

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Directions to “ DR. FUN CHI TU MD” Practice Location

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