Provider Demographics
NPI:1952410052
Name:MIN, ZAW (MD)
Entity Type:Individual
Prefix:
First Name:ZAW
Middle Name:
Last Name:MIN
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 1:612 W. DUARTE RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9234
Mailing Address - Country:US
Mailing Address - Phone:626-446-1894
Mailing Address - Fax:626-446-8314
Practice Address - Street 1:612 W. DUARTE RD
Practice Address - Street 2:SUITE 402
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9234
Practice Address - Country:US
Practice Address - Phone:626-446-1894
Practice Address - Fax:626-446-8314
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40852207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A408520Medicaid
A85520Medicare UPIN
CA00A408520Medicaid