Provider Demographics
NPI:1154138717
Name:LWIN, PWINT PHYU
Entity type:Individual
Prefix:
First Name:PWINT
Middle Name:PHYU
Last Name:LWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 NOEMI DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-1443
Mailing Address - Country:US
Mailing Address - Phone:415-299-7972
Mailing Address - Fax:
Practice Address - Street 1:1811 NOEMI DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-1443
Practice Address - Country:US
Practice Address - Phone:415-299-7972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCH-184576183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician