Provider Demographics
NPI:1235352394
Name:KUNG, BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:KUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11035 LAVENDER HILL DR # 160-589
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-2955
Mailing Address - Country:US
Mailing Address - Phone:267-515-4199
Mailing Address - Fax:
Practice Address - Street 1:3692 E SUNSET RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-7237
Practice Address - Country:US
Practice Address - Phone:702-735-7668
Practice Address - Fax:702-735-1411
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0007869207Y00000X
CAA103146207YX0901X
WA60913455207YX0901X
NV21963207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology