Basic Information
| Provider Information | |||||||||
| NPI: | 1578653515 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AYE | ||||||||
| FirstName: | KHIN | ||||||||
| MiddleName: | MAUNG | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4001 KING AVE | ||||||||
| Address2: | |||||||||
| City: | CORCORAN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932129611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5599928800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4001 KING AVE | ||||||||
| Address2: | |||||||||
| City: | CORCORAN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932129611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5599928800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 09/10/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A76549 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.