Provider Demographics
NPI:1588693261
Name:AUNG, KAE T (MD)
Entity type:Individual
Prefix:
First Name:KAE
Middle Name:T
Last Name:AUNG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7373 WEST LN
Mailing Address - Street 2:STE 165
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-3377
Mailing Address - Country:US
Mailing Address - Phone:530-876-7820
Mailing Address - Fax:530-876-7805
Practice Address - Street 1:6470 PENTZ RD
Practice Address - Street 2:SUITE B
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-3674
Practice Address - Country:US
Practice Address - Phone:530-876-7820
Practice Address - Fax:530-876-7805
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2021-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0051738207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
07391OtherPREFERRED HEALTH NETWORK
1010184OtherAETNA HMO
DC13070003OtherCAREFIRST OF DC
52029-01OtherAMERIGROUP
CAA73806OtherPROFESSIONAL LICENSURE
CABM797OtherMEDICARE
MDP13195OtherCAREFIRST BCBS POS
DC4421680Medicaid
5293630OtherAETNA
1220043OtherFIRST HEALTH/CCN
MD54733401OtherCAREFIRST BCBS
8964863002OtherCIGNA
MD134250900Medicaid
2429707OtherUNITED HEALTHCARE
855698OtherMAMSI
DG3783OtherRAILROAD MEDICARE
CAA73806OtherPROFESSIONAL LICENSURE
MD134250900Medicaid