Provider Demographics
NPI:1013011642
Name:MYAING, HLA
Entity Type:Individual
Prefix:DR
First Name:HLA
Middle Name:
Last Name:MYAING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 E ROMIE LANE
Mailing Address - Street 2:STE C
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4222
Mailing Address - Country:US
Mailing Address - Phone:831-758-0122
Mailing Address - Fax:831-758-8527
Practice Address - Street 1:770 E ROMIE LANE
Practice Address - Street 2:STE C
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4222
Practice Address - Country:US
Practice Address - Phone:831-758-0122
Practice Address - Fax:831-758-8527
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49608122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1557340OtherUNITED CONCORDIA
CAB49608OtherHFP STATE GOVERNMENT PROG
CAG9272101Medicaid