Healthcare Provider Details

I. General information

NPI: 1801080445
Provider Name (Legal Business Name): ANDREW MYINT LEONG M.D.,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MYINT MAUNG M.B.B.S.,

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 WEST CECIL AVENUE
DELANO CA
93216
US

IV. Provider business mailing address

PO BOX 22014
BAKERSFIELD CA
93390-2014
US

V. Phone/Fax

Practice location:
  • Phone: 661-721-2345
  • Fax: 661-721-3124
Mailing address:
  • Phone: 661-664-5726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA63767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: