Healthcare Provider Details

I. General information

NPI: 1235491838
Provider Name (Legal Business Name): THANDA ZAW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 POMONA BLVD
EAST LOS ANGELES CA
90022-1716
US

IV. Provider business mailing address

PO BOX 5111
PASADENA CA
91117-0111
US

V. Phone/Fax

Practice location:
  • Phone: 323-728-0411
  • Fax:
Mailing address:
  • Phone: 818-850-5332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA134244
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2015020786
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: