Provider Demographics
NPI:1720398696
Name:MUNIR JAVED MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MUNIR JAVED MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUNIR
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-940-1335
Mailing Address - Street 1:2204 GRANT RD STE 203
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-3877
Mailing Address - Country:US
Mailing Address - Phone:650-940-1335
Mailing Address - Fax:650-968-2723
Practice Address - Street 1:2204 GRANT RD STE 203
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3877
Practice Address - Country:US
Practice Address - Phone:650-940-1335
Practice Address - Fax:650-968-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49052207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF35334Medicare UPIN