Individual provider Active NPI

Khine Win Phyu, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • El Monte, CA
National Provider Identifier
1639296700
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
12471 Issued in NV
Practice address
10418 Valley Blvd
Altamed SBC Pace -El Monte
El Monte, CA 91731-3600
Phone
(626) 258-1600
Fax
(626) 258-1609
NPI assigned
Mar 23, 2007
Last updated
Feb 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 12471 NV Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 12471 NV

Addresses

Primary practice location

10418 Valley Blvd
Altamed SBC Pace -El Monte
El Monte, CA 91731-3600

Mailing address

10418 Valley Blvd
Altamed SBC Pace -El Monte
El Monte, CA 91731-3600
Phone (626) 258-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121101000337 CA Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 1254489180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
106621CAMDDentist
12471NEMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1639296700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10418 VALLEY BLVD",
            "address_2": "ALTAMED SBC PACE -EL MONTE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917313600",
            "telephone_number": "626-258-1600",
            "fax_number": "626-258-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10418 VALLEY BLVD",
            "address_2": "ALTAMED SBC PACE -EL MONTE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917313600",
            "telephone_number": "626-258-1600",
            "fax_number": "626-258-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHYU",
        "first_name": "KHINE",
        "middle_name": "WIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NV",
            "license": "12471",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NV",
            "license": "12471",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.