Healthcare Provider Details

I. General information

NPI: 1003264011
Provider Name (Legal Business Name): PWINT PHYU KHINE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVENUE BLDG. 5, 1ST FLOOR
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

1001 POTRERO AVENUE BLDG. 5, 1ST FLOOR
SAN FRANCISCO CA
94110
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number20A18632
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberOS022518
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: