Provider Demographics
NPI:1306993993
Name:MUNIR, TABASSUM (RD)
Entity type:Individual
Prefix:MS
First Name:TABASSUM
Middle Name:
Last Name:MUNIR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:TABASSUM
Other - Middle Name:
Other - Last Name:MUNIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:3152 CHARDONNAY DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6967
Mailing Address - Country:US
Mailing Address - Phone:925-461-2955
Mailing Address - Fax:925-461-2954
Practice Address - Street 1:1440 168TH AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2409
Practice Address - Country:US
Practice Address - Phone:510-481-6319
Practice Address - Fax:510-481-6310
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA943494133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered