Individual
DR. THAN AYE AW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5088 N FRESNO ST STE 104, FRESNO, CA 93710-7611
(559) 222-9362
(559) 222-9369
Mailing address
143 W MAIN ST STE 104, MERCED, CA 95340-4930
(209) 725-2060
(209) 725-2072
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
A53206
CA
171100000X
Acupuncturist
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A53206
CA
261Q00000X
Clinic/Center
A53206
CA
314000000X
Skilled Nursing Facility
A53206
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A532060
—
CA
01
—
770473417
TAX ID
CA
Enumeration date
07/30/2006
Last updated
01/22/2026
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