Provider Demographics
NPI:1376250449
Name:MUNA, GHADAH (RPH)
Entity Type:Individual
Prefix:
First Name:GHADAH
Middle Name:
Last Name:MUNA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 ORO ST APT 25
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-4956
Mailing Address - Country:US
Mailing Address - Phone:619-569-6078
Mailing Address - Fax:
Practice Address - Street 1:1111 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3105
Practice Address - Country:US
Practice Address - Phone:619-691-1308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86492183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist