| Flagstaff Neurology | |
|
4275 Executive Sq Ste 200 La Jolla CA 92037-1476 | |
| (619) 403-1701 | |
| Not Available |
| Full Name | Flagstaff Neurology |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 4275 Executive Sq Ste 200, La Jolla, California |
| Authorized Official Name and Position | Panna Shah (PHYSICCIAN OWNER) |
| Authorized Official Contact | 6194031701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Flagstaff Neurology 618 N Humphreys St Flagstaff AZ 86001-3024 Ph: (928) 774-2459 | Flagstaff Neurology 4275 Executive Sq Ste 200 La Jolla CA 92037-1476 Ph: (619) 403-1701 |
| NPI Number | 1518136241 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 08/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518136241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 33297 (Arizona) | Primary |
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