Provider Demographics
NPI:1639213762
Name:BERNARD C ONG, MD, PC
Entity Type:Organization
Organization Name:BERNARD C ONG, MD, PC
Other - Org Name:BERNARD ONG, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-796-7979
Mailing Address - Street 1:10300 W CHARLESTON BLVD
Mailing Address - Street 2:#13-141
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1037
Mailing Address - Country:US
Mailing Address - Phone:702-796-7979
Mailing Address - Fax:702-456-7979
Practice Address - Street 1:8551 W LAKE MEAD BLVD
Practice Address - Street 2:SUITE 251
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7642
Practice Address - Country:US
Practice Address - Phone:702-796-7979
Practice Address - Fax:702-456-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10098332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVH64593Medicare UPIN
NV101638Medicare ID - Type Unspecified
NV101639Medicare ID - Type Unspecified