Provider Demographics
NPI:1598085003
Name:VILAI, JULPOHNG (MD)
Entity Type:Individual
Prefix:
First Name:JULPOHNG
Middle Name:
Last Name:VILAI
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 1:3016 W CHARLESTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1973
Mailing Address - Country:US
Mailing Address - Phone:702-780-2311
Mailing Address - Fax:
Practice Address - Street 1:1524 PINTO LN FL 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4195
Practice Address - Country:US
Practice Address - Phone:702-944-2828
Practice Address - Fax:702-944-2852
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PHYS-LIC-34868208000000X
DCMD041734208000000X
MDD0076485208000000X
NV19983208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics