Provider Demographics
NPI:1396779450
Name:TIN, SANSAN MYINT (MD)
Entity type:Individual
Prefix:
First Name:SANSAN
Middle Name:MYINT
Last Name:TIN
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 1:3944 PASADENA DR
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3643
Mailing Address - Country:US
Mailing Address - Phone:650-349-3988
Mailing Address - Fax:415-334-2584
Practice Address - Street 1:1800 31ST AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4229
Practice Address - Country:US
Practice Address - Phone:415-677-2388
Practice Address - Fax:415-217-4198
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93869207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine