Provider Demographics
NPI:1477267839
Name:SANDAR KYI MD, APC
Entity type:Organization
Organization Name:SANDAR KYI MD, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-567-4662
Mailing Address - Street 1:1349 VIA DEL REY
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-3630
Mailing Address - Country:US
Mailing Address - Phone:951-567-4662
Mailing Address - Fax:
Practice Address - Street 1:9701 LAKEWOOD BLVD # A
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3311
Practice Address - Country:US
Practice Address - Phone:951-567-4662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty