SOE TIN MAUNGLAY (NPI# 1093864373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093864373 |
| Entity Type | Individual |
| Full Name | SOE TIN MAUNGLAY |
| Credential | MD |
| Practice Address |
4500 Brockton Ave Ste 316 Riverside CA 92501-4090 |
| Mailing Address |
51753 El Dorado Dr La Quinta CA 92253-9034 |
| Practice Telephone | 9513943055 |
| Practice Fax Number | 9513943077 |
| Mailing Telephone | 7606192309 |
| Mailing Fax Number | 8664280708 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-09-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
C152411 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE | P17390012 | 01 |
| FL | 277913700 | 05 | |
| AL | AL MEDICAID- GULF BREEZE | 124241 | 01 |
| AL | AL MEDICAID- NORTH DAVIS | 124237 | 01 |
| AL | AL MEDICAID- BREWTON | 124493 | 01 |
| MI | BLUE CROSS BLUE SHEILD | 093-896 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1180 N Indian Canyon Dr Ste E218, Palm Springs, CA 922624885 | 7604164800 |
| Street Address |
4500 BROCKTON AVE STE 316 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92501-4090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437605 | Mary Horvatin | Technician | 1811 Rivera Strret, Riverside, CA 92501 | 2019-09-23 |
| 1366905473 | Timothy Daniel Collins | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme, Office, Riverside, CA 92501 | 2019-04-08 |
| 1346709672 | Lourdes Adame | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Ave - Gme Office, Riverside, CA 92501 | 2019-03-16 |
| 1740759067 | Kristina Ferris-celosse | Counselor | 2452 Wilshire St., Riverside, CA 92501 | 2018-11-15 |
| 1750888095 | Arunmozhi Aravagiri | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, Gme Office, 4445 Magnolia Ave., Riverside, CA 92501 | 2018-04-12 |
| 1720585847 | Alan Huynh | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue., Gme Office, Riverside, CA 92501 | 2018-04-06 |
| 1538664834 | Wilson Paul Frasca | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue, Riverside, CA 92501 | 2018-03-28 |
| 1851896575 | Geethu Gopinathan Nair | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme Office, Riverside, CA 92501 | 2018-03-26 |
| 1316465560 | Thilini Anne Abeygunaratne | Marriage & Family Therapist | 1950 Market Street, Riverside, CA 92501 | 2017-09-07 |
| 1194257410 | Melissa Chitwood | Assistant Behavior Analyst | 3078 Cedar St., Riverside, CA 92501 | 2017-03-28 |
| Find all providers in zip 92501 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205271640 | Gregory Alan Gilmore | Internal Medicine | 4646 Brockton Ave Ste 203-2, Riverside, CA 92506-0173 | 2013-04-29 |
| 1508185406 | Laxmi Sudarshan Iyer | Internal Medicine | 4500 Brockton Ave Ste 107, Riverside, CA 92501-4006 | 2010-05-18 |
| 1205028404 | Annie Lee Oh | Internal Medicine | 10800 Magnolia Ave # 438, Riverside, CA 92505 | 2007-08-13 |
| 1174654818 | Indrani Gill | Internal Medicine | 4000 14th St Ste 409, Riverside, CA 92501-4010 | 2007-03-07 |
| 1174628093 | Stanley G. Schade | Internal Medicine | 189 North Delaplaine Road, Riverside, IL 60546-3728 | 2006-09-14 |
| 1295993111 | Vishal Navnitray Ranpura | Internal Medicine | 10800 Magnolia Ave, Department of Medicine, Riverside, CA 92505-3043 | 2008-05-28 |
| 1902950033 | Vaishali Vishal Saste | Internal Medicine | 7117 Brockton Ave, Riverside, CA 92506-2615 | 2007-01-23 |
| 1407904451 | Candice A. Ruby | Internal Medicine | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2007-01-08 |
| 1285793893 | Nader A. Kashani | Internal Medicine | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2006-12-08 |
| 1386703031 | Andy S. Jang | Internal Medicine | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2006-12-08 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.