Provider Demographics
NPI:1063527463
Name:ZAW, MYINT (MD)
Entity type:Individual
Prefix:DR
First Name:MYINT
Middle Name:
Last Name:ZAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11289 N VIA PALMERO WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-8820
Mailing Address - Country:US
Mailing Address - Phone:559-436-0144
Mailing Address - Fax:559-573-7254
Practice Address - Street 1:6246 N FIRST ST
Practice Address - Street 2:STE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5480
Practice Address - Country:US
Practice Address - Phone:559-436-0144
Practice Address - Fax:559-436-4395
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80790207R00000X, 208M00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A807900Medicare ID - Type Unspecified
CAH85199Medicare UPIN