Provider Demographics
NPI:1922007913
Name:TIAN, YU (MD)
Entity Type:Individual
Prefix:
First Name:YU
Middle Name:
Last Name:TIAN
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 1:6655 W SAHARA AVE STE B200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-2832
Mailing Address - Country:US
Mailing Address - Phone:702-222-3238
Mailing Address - Fax:702-221-2231
Practice Address - Street 1:6655 W SAHARA AVE STE B200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-2832
Practice Address - Country:US
Practice Address - Phone:702-222-3238
Practice Address - Fax:702-221-2231
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11340207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506048Medicaid
NV100506048Medicaid
NV100927Medicare ID - Type Unspecified