Provider Demographics
NPI:1508800046
Name:POON-CHUE, ALICE HUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:HUNG
Last Name:POON-CHUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALICE
Other - Middle Name:HUNG OR POON
Other - Last Name:CHUE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 36900
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-6900
Mailing Address - Country:US
Mailing Address - Phone:702-240-1215
Mailing Address - Fax:702-243-7531
Practice Address - Street 1:2950 S MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2204
Practice Address - Country:US
Practice Address - Phone:702-240-1215
Practice Address - Fax:702-243-7531
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV85742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018684Medicaid
NV34035Medicare ID - Type Unspecified
NV002018684Medicaid