Healthcare Provider Details
I. General information
NPI: 1639064850
Provider Name (Legal Business Name): KYAW LIN, DO INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
675 YGNACIO VALLEY RD STE A102
WALNUT CREEK CA
94596-3882
US
IV. Provider business mailing address
52 GOLF CLUB RD # 154
PLEASANT HILL CA
94523-1524
US
V. Phone/Fax
- Phone: 925-938-5252
- Fax:
- Phone: 925-451-4688
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KYAW
Z
LIN
Title or Position: PRESIDENT
Credential: DO
Phone: 925-451-4688