Healthcare Provider Details

I. General information

NPI: 1063894814
Provider Name (Legal Business Name): PYE AUNG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2015
Last Update Date: 05/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W AVENUE J
LANCASTER CA
93534-2814
US

IV. Provider business mailing address

18565 COLIMA RD APT H
ROWLAND HEIGHTS CA
91748-2818
US

V. Phone/Fax

Practice location:
  • Phone: 661-726-6254
  • Fax:
Mailing address:
  • Phone: 309-750-7307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA156618
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA156618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: