MEDICARE: DR. KYAW K SOE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	55189	CA

General Provider Information

NPI Number	:	1861542268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYAW K SOE

Provider Business Mailing Address
First Line	:	195 TALBERT ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94134-2914
Country	:	US
Telephone Number	:	415-333-4214
Fax Number	:

Provider Business Practice Location Address
First Line	:	4747 MISSION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94112-2729
Country	:	US
Telephone Number	:	415-585-5773
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	04/04/2022

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Directions to “ DR. KYAW K SOE ” Practice Location

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