Provider Demographics
NPI:1134425820
Name:CHASE, CYNTHIA (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10620 SOUTHERN HIGHLANDS PKWY
Mailing Address - Street 2:SUITE 110-513
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4371
Mailing Address - Country:US
Mailing Address - Phone:702-457-5437
Mailing Address - Fax:702-464-5801
Practice Address - Street 1:3201 S MARYLAND PKWY
Practice Address - Street 2:SUITE 608
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2441
Practice Address - Country:US
Practice Address - Phone:702-457-5437
Practice Address - Fax:702-464-5801
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14847208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics