MEDICARE: BINH MINH CHUNG 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
1	207Q00000X	Family Medicine Physician	11281	NV

General Provider Information

NPI Number	:	1689766693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BINH MINH CHUNG M.D.

Provider Business Mailing Address
First Line	:	7345 S DURANGO DR B107 MAILBOX 52
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3608
Country	:	US
Telephone Number	:	170-236-0330
Fax Number	:	170-273-6630

Provider Business Practice Location Address
First Line	:	7345 S DURANGO DR # B107
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3608
Country	:	US
Telephone Number	:	702-301-9123
Fax Number	:	702-240-0414

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	12/12/2007

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