Provider Demographics
NPI:1548668718
Name:MURAN, SANDRA YVONNE (PHD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:YVONNE
Last Name:MURAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:YVONNE
Other - Last Name:MURAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1024 BAYSIDE DR # 212
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7462
Mailing Address - Country:US
Mailing Address - Phone:949-338-1274
Mailing Address - Fax:805-548-0988
Practice Address - Street 1:1024 BAYSIDE DR # 212
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7462
Practice Address - Country:US
Practice Address - Phone:949-338-1274
Practice Address - Fax:805-548-0988
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist