Provider Demographics
NPI:1922339191
Name:QUINLAN, MUNIRIH AMELIA (RD)
Entity Type:Individual
Prefix:MS
First Name:MUNIRIH
Middle Name:AMELIA
Last Name:QUINLAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 WESLEY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1065
Mailing Address - Country:US
Mailing Address - Phone:217-778-8274
Mailing Address - Fax:
Practice Address - Street 1:548 WESLEY AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-1065
Practice Address - Country:US
Practice Address - Phone:217-778-8274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01046126133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered