Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | A4078 | CA |
Y | 207R00000X | Internist | A4078 | CA |
Y | 111NI0900X | Internist | A4078 | CA |
N | 207RA0401X | Internist - Addiction Medicine | A4078 | CA |
NPI | 1154479525 |
---|---|
Provider Name | Dr. Peter John Muran |
First Address | Newport Beach, CA 92660-7462 |
Second Address | Newport Beach, CA 92660-1421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 16/10/2018 |