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NPI Code Detail

MEDICARE: DR. KIRAN SUFIAN MUNIR M.D

MEDICARE: DR. KIRAN SUFIAN MUNIR M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician125063649IL
22084P0804XChild & Adolescent Psychiatry Physician036140362IL

General Provider Information

NPI Number : 1083054639
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIRAN SUFIAN MUNIR M.D
Provider Business Mailing Address
First Line : PO BOX 1770
Second Line :
City : LA MESA
State : CA
Zip : 91944-1770
Country : US
Telephone Number : 858-630-5442
Fax Number : 858-552-0910
Provider Business Practice Location Address
First Line : 8170 MIRAMAR RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92126-4321
Country : US
Telephone Number : 858-630-5442
Fax Number : 858-552-0910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2013
Last Update Date : 03/26/2020

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