Provider Demographics
NPI:1497927610
Name:TU, FUN CHI (MD)
Entity Type:Individual
Prefix:DR
First Name:FUN CHI
Middle Name:
Last Name:TU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FUN-CHI
Other - Middle Name:
Other - Last Name:TU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6625 W SAHARA AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0856
Mailing Address - Country:US
Mailing Address - Phone:725-202-3439
Mailing Address - Fax:725-214-4636
Practice Address - Street 1:6625 W SAHARA AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0856
Practice Address - Country:US
Practice Address - Phone:725-202-3439
Practice Address - Fax:725-214-4636
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118249207R00000X
NV14948208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1497927610Medicaid
NV14948OtherSTATE LICENSE