Provider Demographics
NPI:1083054639
Name:MUNIR, KIRAN SUFIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:SUFIAN
Last Name:MUNIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIRAN
Other - Middle Name:
Other - Last Name:SANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1770
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91944-1770
Mailing Address - Country:US
Mailing Address - Phone:858-630-5442
Mailing Address - Fax:858-552-0910
Practice Address - Street 1:8170 MIRAMAR RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4321
Practice Address - Country:US
Practice Address - Phone:858-630-5442
Practice Address - Fax:858-552-0910
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1250636492084P0800X
IL0361403622084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry