Healthcare Provider Details

I. General information

NPI: 1659533982
Provider Name (Legal Business Name): AYE T KHYNE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 08/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 HIGH SCHOOL AVE # 208
CONCORD CA
94520-1817
US

IV. Provider business mailing address

2485 HIGH SCHOOL AVE #208
CONCORD CA
94520-1819
US

V. Phone/Fax

Practice location:
  • Phone: 925-671-7629
  • Fax:
Mailing address:
  • Phone: 925-671-7629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA99556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: