Provider Demographics
NPI:1821392390
Name:VIENNA, MUNA (MD)
Entity Type:Individual
Prefix:
First Name:MUNA
Middle Name:
Last Name:VIENNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MUNA
Other - Middle Name:
Other - Last Name:ABDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1275 QUARRY ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1707
Mailing Address - Country:US
Mailing Address - Phone:951-737-6040
Mailing Address - Fax:
Practice Address - Street 1:1275 QUARRY ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1707
Practice Address - Country:US
Practice Address - Phone:951-737-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74342146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant