Provider Demographics
NPI:1770924060
Name:MUNNAINATHAN, PARTHIBAN (MD)
Entity type:Individual
Prefix:DR
First Name:PARTHIBAN
Middle Name:
Last Name:MUNNAINATHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 CALIFORNIA AVE
Mailing Address - Street 2:SUITE 400-B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7024
Mailing Address - Country:US
Mailing Address - Phone:800-300-6664
Mailing Address - Fax:661-459-1944
Practice Address - Street 1:4900 CALIFORNIA AVE
Practice Address - Street 2:SUITE 400-B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7024
Practice Address - Country:US
Practice Address - Phone:800-300-6664
Practice Address - Fax:661-459-1944
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301103292207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine