Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301104681 | MI |
N | 111NI0900X | Internist | 4301104681 | MI |
Y | 207R00000X | Internist | A149079 | CA |
Y | 111NI0900X | Internist | A149079 | CA |
N | 207RG0300X | Geriatric Medicine | A149079 | CA |
NPI | 1083022925 |
---|---|
Provider Name | Myo Kyaw Zaw |
First Address | Sacramento, CA 95865-5228 |
Second Address | Stockton, CA 95209-2839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 07/06/2021 |