Provider Demographics
NPI:1962701219
Name:AHN, BYUNG CHAN THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:BYUNG CHAN
Middle Name:THOMAS
Last Name:AHN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:135 N SIERRA ST # 40595
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-1344
Mailing Address - Country:US
Mailing Address - Phone:714-457-0075
Mailing Address - Fax:800-583-1756
Practice Address - Street 1:7111 S VIRGINIA ST STE D2
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1141
Practice Address - Country:US
Practice Address - Phone:775-870-1230
Practice Address - Fax:833-606-1557
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.00558902084N0400X
IL1250604352084N0400X
NV181332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV13746319OtherCAQH NUMBER
NV18133OtherMEDICAL LICENSE