Provider Demographics
NPI:1811987845
Name:CHEN, EUGENE Y (MD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:Y
Last Name:CHEN
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 1:3230 E FLAMINGO RD
Mailing Address - Street 2:#334
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4320
Mailing Address - Country:US
Mailing Address - Phone:702-454-8236
Mailing Address - Fax:702-454-8236
Practice Address - Street 1:3230 E FLAMINGO RD
Practice Address - Street 2:#334
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4320
Practice Address - Country:US
Practice Address - Phone:702-454-8236
Practice Address - Fax:702-454-8236
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6251174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVE91516Medicare UPIN
NVMD6251Medicare ID - Type Unspecified