Provider Demographics
NPI:1770793853
Name:UWAYDAH, MUNIR M (MD)
Entity type:Individual
Prefix:
First Name:MUNIR
Middle Name:M
Last Name:UWAYDAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2800 NEILSON WAY # 116
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4025
Mailing Address - Country:US
Mailing Address - Phone:310-399-7824
Mailing Address - Fax:
Practice Address - Street 1:211 S MACLAY AVE
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-3603
Practice Address - Country:US
Practice Address - Phone:818-700-1250
Practice Address - Fax:818-700-1045
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA62059207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG78175Medicare UPIN