Provider Demographics
NPI:1144384157
Name:KYAW LYN MD INC
Entity Type:Organization
Organization Name:KYAW LYN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYAW
Authorized Official - Middle Name:
Authorized Official - Last Name:LYN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-960-1902
Mailing Address - Street 1:906 S SUNSET AVE
Mailing Address - Street 2:SUITE101
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3400
Mailing Address - Country:US
Mailing Address - Phone:626-960-1902
Mailing Address - Fax:626-960-3982
Practice Address - Street 1:906 S SUNSET AVE
Practice Address - Street 2:SUITE101
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3400
Practice Address - Country:US
Practice Address - Phone:626-960-1902
Practice Address - Fax:626-960-3982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54425207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A544250Medicaid
CA00A544250Medicaid
CAG53743Medicare UPIN