MEDICARE: JULPOHNG VILAI 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	208000000X	Pediatrics Physician	MED-PHYS-LIC-34868	MT
2	208000000X	Pediatrics Physician	19983	NV
3	208000000X	Pediatrics Physician	D0076485	MD
4	208000000X	Pediatrics Physician	MD041734	DC

General Provider Information

NPI Number	:	1598085003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULPOHNG VILAI MD

Provider Business Mailing Address
First Line	:	3016 W CHARLESTON BLVD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1973
Country	:	US
Telephone Number	:	702-780-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	5380 S RAINBOW BLVD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1878
Country	:	US
Telephone Number	:	702-463-4040
Fax Number	:

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

Provider Enumeration Date	:	06/07/2010
Last Update Date	:	11/06/2025

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Directions to “ JULPOHNG VILAI MD” Practice Location

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