Provider Demographics
NPI:1710157177
Name:JANG S MUN MD PC
Entity Type:Organization
Organization Name:JANG S MUN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANG
Authorized Official - Middle Name:S
Authorized Official - Last Name:MUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-643-0740
Mailing Address - Street 1:2931 N TENAYA WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0457
Mailing Address - Country:US
Mailing Address - Phone:702-643-0740
Mailing Address - Fax:888-291-5713
Practice Address - Street 1:2931 N TENAYA WAY STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0457
Practice Address - Country:US
Practice Address - Phone:702-643-0740
Practice Address - Fax:888-291-5713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-01
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV101260Medicare UPIN