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General NPI Number Information
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NPI Number | 1407851777
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Entity Type | Individual
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Provider Name | NINA KHIN MAW MAW M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 35900 BOB HOPE DR STE 230
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1767
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Country | US
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Telephone | 760-778-7147
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Fax | 760-416-5025
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Provider Business Mailing Address
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Address Line | 62 CALLE MANZANITA
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4140
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Country | US
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Telephone | 760-836-0110
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Fax | 760-836-0110
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A79700
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License Number State | CA
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