Provider Demographics
NPI:1871538876
Name:YOUNG, CHEN (OD)
Entity type:Individual
Prefix:DR
First Name:CHEN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:CHEN
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:8880 W. CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117
Mailing Address - Country:US
Mailing Address - Phone:702-938-2020
Mailing Address - Fax:702-938-2034
Practice Address - Street 1:8880 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5454
Practice Address - Country:US
Practice Address - Phone:702-938-2020
Practice Address - Fax:702-938-2034
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV318152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1260850001Medicare NSC
NVU47034Medicare UPIN