MEDICARE: ARTHUR S TAYENGCO, MD CHARTERED

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	261Q00000X	Clinic/Center	2688	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

General Provider Information

NPI Number	:	1659618189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTHUR S TAYENGCO, MD CHARTERED

Provider Business Mailing Address
First Line	:	3515 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1839
Country	:	US
Telephone Number	:	702-382-1033
Fax Number	:	702-382-9507

Provider Business Practice Location Address
First Line	:	3515 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1839
Country	:	US
Telephone Number	:	702-382-1033
Fax Number	:	702-382-9507

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ARTHUR S TAYENGCO
Credential	:	M.D.
Telephone Number	:	702-382-1033

Provider Enumeration Date	:	01/03/2013
Last Update Date	:	01/03/2013

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