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NPI Code Detail

MEDICARE: DR. ANDY YINGJU MU O.D.

MEDICARE: DR. ANDY YINGJU MU 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
1152WC0802XCorneal and Contact Management Optometrist793NV
2152W00000XOptometrist793NV

Other Identifiers

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

General Provider Information

NPI Number : 1629418728
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDY YINGJU MU O.D.
Provider Business Mailing Address
First Line : 11035 LAVENDER HILL DR
Second Line : STE 160-288
City : LAS VEGAS
State : NV
Zip : 89135-2957
Country : US
Telephone Number : 702-913-8406
Fax Number : 253-399-8410
Provider Business Practice Location Address
First Line : 2390 W HORIZON RIDGE PKWY STE 100
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5084
Country : US
Telephone Number : 702-825-2085
Fax Number : 702-852-5743
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2013
Last Update Date : 01/03/2024

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