Provider Demographics
NPI:1841226636
Name:CHEN, YUAN-CHUNG (DO)
Entity Type:Individual
Prefix:DR
First Name:YUAN-CHUNG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:PHIL
Other - Middle Name:YUAN-CHUNG
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:219 N PECOS RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7359
Mailing Address - Country:US
Mailing Address - Phone:702-260-7818
Mailing Address - Fax:702-260-7238
Practice Address - Street 1:219 N PECOS RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7359
Practice Address - Country:US
Practice Address - Phone:702-260-7818
Practice Address - Fax:702-260-7238
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV871208VP0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018424Medicaid
NV002018424Medicaid
NVG81313Medicare UPIN