Provider Demographics
NPI:1285908111
Name:HTAY, ANDRE AUNG-KO (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:AUNG-KO
Last Name:HTAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2615 E CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-2223
Mailing Address - Country:US
Mailing Address - Phone:595-225-6100
Mailing Address - Fax:559-248-5225
Practice Address - Street 1:2615 E CLINTON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-2223
Practice Address - Country:US
Practice Address - Phone:559-225-6100
Practice Address - Fax:559-248-5225
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA137464207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine