MEDICARE: EELING ELAINE GOH, PLLC

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	152W00000X	Optometrist	660	NV

General Provider Information

NPI Number	:	1942540885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EELING ELAINE GOH, PLLC

Provider Business Mailing Address
First Line	:	640 E DEER SPRINGS WAY
Second Line	:	STE 140
City	:	N LAS VEGAS
State	:	NV
Zip	:	89086-1512
Country	:	US
Telephone Number	:	702-510-0357
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 E DEER SPRINGS WAY
Second Line	:	STE 140
City	:	N LAS VEGAS
State	:	NV
Zip	:	89086-1512
Country	:	US
Telephone Number	:	702-510-0357
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	EELING ELAINE GOH
Credential	:	O.D.
Telephone Number	:	626-201-3609

Provider Enumeration Date	:	02/28/2013
Last Update Date	:	02/28/2013

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