Provider Demographics
NPI:1902042542
Name:MYINT, WIN WIN (MD)
Entity Type:Individual
Prefix:DR
First Name:WIN
Middle Name:WIN
Last Name:MYINT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:WIN
Other - Middle Name:WIN
Other - Last Name:MYINT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2619 E TARRAGON WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4928
Mailing Address - Country:US
Mailing Address - Phone:917-254-5648
Mailing Address - Fax:
Practice Address - Street 1:7300 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2941
Practice Address - Country:US
Practice Address - Phone:917-254-5648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-04
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA115860207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine