Healthcare Provider Details

I. General information

NPI: 1851959720
Provider Name (Legal Business Name): KYI ZIN M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PLAZA DR
ROSEVILLE CA
95661-3037
US

IV. Provider business mailing address

1420 E ROSEVILLE PKWY, STE 140 PMB 326
ROSEVILLE CA
95661
US

V. Phone/Fax

Practice location:
  • Phone: 916-865-6672
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KYI ZIN
Title or Position: PRESIDENT
Credential: MD
Phone: 916-865-6672