Basic Information
Provider Information
NPI: 1720405004
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHING
FirstName: HARRY
MiddleName: HSIN-JONG
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3016 W CHARLESTON BLVD
Address2: STE 100
City: LAS VEGAS
State: NV
PostalCode: 891021973
CountryCode: US
TelephoneNumber: 7022180915
FaxNumber:  
Practice Location
Address1: 5320 S RAINBOW BLVD STE 250
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891181896
CountryCode: US
TelephoneNumber: 7026716480
FaxNumber: 7026716481
Other Information
ProviderEnumerationDate: 03/25/2014
LastUpdateDate: 11/30/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/30/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000XA157725CAN Allopathic & Osteopathic PhysiciansOtolaryngology 
207YS0123XA157725CAN Allopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
207Y00000X19869NVY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


Home