Provider Demographics
NPI:1407160906
Name:CHEUNG, KA YAN (OD)
Entity Type:Individual
Prefix:DR
First Name:KA YAN
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 S DECATUR BLVD
Mailing Address - Street 2:#6
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-0050
Mailing Address - Country:US
Mailing Address - Phone:702-876-2020
Mailing Address - Fax:702-876-0005
Practice Address - Street 1:2580 S DECATUR BLVD
Practice Address - Street 2:#6
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0050
Practice Address - Country:US
Practice Address - Phone:702-876-2020
Practice Address - Fax:702-876-0005
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV678152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist