Provider Demographics
NPI:1639377450
Name:RITA B. CHUANG, MD LLC
Entity Type:Organization
Organization Name:RITA B. CHUANG, MD LLC
Other - Org Name:RITA B. CHUANG, MD LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:BELLA
Authorized Official - Last Name:CHUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-818-3207
Mailing Address - Street 1:2629 W HORIZON RIDGE PKWY
Mailing Address - Street 2:140
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2897
Mailing Address - Country:US
Mailing Address - Phone:702-818-3207
Mailing Address - Fax:702-818-4759
Practice Address - Street 1:2629 W HORIZON RIDGE PKWY
Practice Address - Street 2:140
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2897
Practice Address - Country:US
Practice Address - Phone:702-818-3207
Practice Address - Fax:702-818-4759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9659207Q00000X
NV8906207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2018639Medicaid
NV36301Medicare ID - Type Unspecified
NV2018639Medicaid
NVH17936Medicare UPIN
NVG37458Medicare ID - Type Unspecified