Healthcare Provider Details

I. General information

NPI: 1063527463
Provider Name (Legal Business Name): MYINT ZAW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/18/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6246 N FIRST ST STE 101
FRESNO CA
93710-5480
US

IV. Provider business mailing address

11289 N VIA PALMERO WAY
FRESNO CA
93730-8820
US

V. Phone/Fax

Practice location:
  • Phone: 559-436-0144
  • Fax: 559-436-4395
Mailing address:
  • Phone: 559-436-0144
  • Fax: 559-573-7254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA80790
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA80790
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA80790
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: