Healthcare Provider Details

I. General information

NPI: 1063751444
Provider Name (Legal Business Name): MOE ZAW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 H ST
CHULA VISTA CA
91910-4328
US

IV. Provider business mailing address

480 H ST
CHULA VISTA CA
91910-4328
US

V. Phone/Fax

Practice location:
  • Phone: 858-939-6570
  • Fax:
Mailing address:
  • Phone: 858-939-6570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA192723
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number285488-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: