Provider Demographics
NPI:1689784308
Name:KYAW, NAING TUN (MD)
Entity Type:Individual
Prefix:
First Name:NAING
Middle Name:TUN
Last Name:KYAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4225 EXECUTIVE SQ STE 450
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8411
Mailing Address - Country:US
Mailing Address - Phone:858-810-0000
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:3300 VISTA WAY STE B
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-3633
Practice Address - Country:US
Practice Address - Phone:760-967-9900
Practice Address - Fax:760-967-6769
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA 97469207RN0300X, 207RN0300X
TXM4257208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA142803OtherNO. CALIFORNIA PTAN
CACB225136OtherSO. CALIFORNIA PTAN
CAA97469OtherCA LICENSE