Healthcare Provider Details

I. General information

NPI: 1518318625
Provider Name (Legal Business Name): KYI MYINT MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HAO MING HSIEH MD

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7140 INDIANA AVE
RIVERSIDE CA
92504
US

IV. Provider business mailing address

26520 CACTUS AVE SUITE 106
MORENO VALLEY CA
92555-3927
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-6000
  • Fax: 951-275-8760
Mailing address:
  • Phone: 951-486-4671
  • Fax: 951-486-5911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA151950
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: