Individual
DR. MIKE Y JEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7391 W CHARLESTON BLVD, SUITE 140, LAS VEGAS, NV 89117-1501
(702) 304-2144
(702) 304-2147
Mailing address
7391 W CHARLESTON BLVD, SUITE 140, LAS VEGAS, NV 89117-1501
(702) 304-2144
(702) 304-2147
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1024
NV
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
1024
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018471
—
NV
Enumeration date
07/06/2006
Last updated
02/20/2018
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