Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | A105297 | CA |
NPI | 1003015215 |
---|---|
Provider Name | Maung Tin |
First Address | South San Francisco, CA 94080-8211 |
Second Address | South San Francisco, CA 94080-8211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2007 |
Last Update Date | 06/12/2018 |