MEDICARE: DR. PETER JOHN MURAN MD

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
1	207QA0401X	Addiction Medicine (Family Medicine) Physician	A4078	CA
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	A4078	CA
3	207R00000X	Internal Medicine Physician	A4078	CA

General Provider Information

NPI Number	:	1154479525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER JOHN MURAN MD

Provider Business Mailing Address
First Line	:	1024 BAYSIDE DR
Second Line	:	STE #212
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7462
Country	:	US
Telephone Number	:	888-315-4777
Fax Number	:	805-548-0988

Provider Business Practice Location Address
First Line	:	1601 DOVE ST STE 170
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-1421
Country	:	US
Telephone Number	:	888-315-4777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	10/16/2018

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