Healthcare Provider Details

I. General information

NPI: 1508274424
Provider Name (Legal Business Name): ZAW MAUNG MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N SAN MATEO DR STE 10
SAN MATEO CA
94401-2674
US

IV. Provider business mailing address

215 N SAN MATEO DR STE 10
SAN MATEO CA
94401-2674
US

V. Phone/Fax

Practice location:
  • Phone: 650-666-3644
  • Fax: 650-889-4036
Mailing address:
  • Phone: 650-666-3644
  • Fax: 650-889-4036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberA138946
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberA138946
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA138946
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: