Charleston Chua MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

CHARLESTON CHUA MD

Practice address

4270 S Decatur Blvd Ste B1B
Las Vegas, NV 89103-6802

Phone

(702) 460-6009

NPI assigned

Sep 22, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charleston Chua, MDNPI 1881937449

Title

Owner

Phone

(702) 460-6009

Specialties & licenses 1

Addresses

Other names 1

• Chua Plastic Surgery Other name

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charleston Chua, M.D.

  • Plastic and Reconstructive Surgery Physician
  • La Mesa, CA
  • NPI 1881937449

  NV

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1013630227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3352 TRANQUIL GARDEN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891173820",
            "telephone_number": "702-460-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 S DECATUR BLVD STE B1B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891036802",
            "telephone_number": "702-460-6009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5495 S Rainbow Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891181873",
            "country_code": "US",
            "telephone_number": "725-529-2482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHARLESTON CHUA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-22",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "CHUA",
        "authorized_official_first_name": "CHARLESTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-460-6009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chua Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chua Plastic Surgery",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Chua Plastic Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kori Charles
• Lakisha Rena Charles
• Michel-Ange Charles
• Nichole Charles
• Tandalaya Charles
• Charleston Chua MD Medical Spa PLLC
• Charleston Pediatric SNF LLC
• Charleston Residential Medicine LLC (CrossRoads Comprehensive Care)
• Charleston Residential Services LLC
• Charleston Residential Services LLC (CrossRoads of Southern Nevada)

• Plastic and Reconstructive Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Plastic and Reconstructive Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.