Provider Demographics
NPI:1881884609
Name:HTUN, LWIN (MD)
Entity type:Individual
Prefix:DR
First Name:LWIN
Middle Name:
Last Name:HTUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-4231
Mailing Address - Country:US
Mailing Address - Phone:951-654-4175
Mailing Address - Fax:951-654-0839
Practice Address - Street 1:341 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-4231
Practice Address - Country:US
Practice Address - Phone:951-654-4175
Practice Address - Fax:951-654-0839
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAH25779207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH25779Medicare UPIN