Provider Demographics
NPI:1083606487
Name:WIN, KYI KYI THWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:KYI KYI
Middle Name:THWIN
Last Name:WIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 GUZZI LANE
Mailing Address - Street 2:STE D
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370
Mailing Address - Country:US
Mailing Address - Phone:909-337-0059
Mailing Address - Fax:909-337-3499
Practice Address - Street 1:690 GUZZI LANE
Practice Address - Street 2:STE D
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370
Practice Address - Country:US
Practice Address - Phone:909-337-0059
Practice Address - Fax:909-337-3499
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56373207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA56373OtherMEDICAL CERTIFICATE
CAA56373OtherMEDICAL CERTIFICATE
CA00A563730Medicare ID - Type Unspecified