Provider Demographics
NPI:1073792172
Name:MYINT, GERALD HLA (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:HLA
Last Name:MYINT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1532 150TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1823
Mailing Address - Country:US
Mailing Address - Phone:510-351-6363
Mailing Address - Fax:510-278-3757
Practice Address - Street 1:27206 CALAROGA AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4300
Practice Address - Country:US
Practice Address - Phone:510-670-1111
Practice Address - Fax:510-670-4772
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2015-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA96837207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA96837OtherMEDICAL LICENSE