Basic Information
| Provider Information | |||||||||
| NPI: | 1386820603 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HLA M. MAUNG M.D. INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HLA M. MAUNG M.D. | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 299 W FOOTHILL BLVD | ||||||||
| Address2: | STE 212 | ||||||||
| City: | UPLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917863804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099498866 | ||||||||
| FaxNumber: | 9093850379 | ||||||||
| Practice Location | |||||||||
| Address1: | 7540 GARVEY AVE | ||||||||
| Address2: | STE C | ||||||||
| City: | ROSEMEAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917702960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099498866 | ||||||||
| FaxNumber: | 9093850379 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2008 | ||||||||
| LastUpdateDate: | 01/16/2008 | ||||||||
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| AuthorizedOfficialLastName: | ALVAREZ | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | UY | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9099498866 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | A55844 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.