Provider Demographics
NPI:1508966490
Name:WIN, KYI (MD)
Entity Type:Individual
Prefix:MR
First Name:KYI
Middle Name:
Last Name:WIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:WINSTON
Other - Middle Name:KW
Other - Last Name:CHAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:78 JUSTIN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502
Mailing Address - Country:US
Mailing Address - Phone:510-769-0487
Mailing Address - Fax:510-769-0487
Practice Address - Street 1:1490 MASON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94130
Practice Address - Country:US
Practice Address - Phone:415-364-7600
Practice Address - Fax:415-986-1130
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51322207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F65679Medicare UPIN