Provider Demographics
NPI:1316978067
Name:CHWA, NILAR MYINT (MD)
Entity type:Individual
Prefix:
First Name:NILAR
Middle Name:MYINT
Last Name:CHWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 W DUARTE RD STE 180
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7609
Mailing Address - Country:US
Mailing Address - Phone:626-821-6411
Mailing Address - Fax:626-821-6414
Practice Address - Street 1:632 W DUARTE RD STE 180
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7609
Practice Address - Country:US
Practice Address - Phone:626-821-6411
Practice Address - Fax:626-821-6414
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61752207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH22725Medicare UPIN
CAA61752Medicare ID - Type Unspecified