| Jefferson Neurology, Llc | |
|
822 Pine St Mount Shasta CA 96067-2137 | |
| (530) 926-1039 | |
| Not Available |
| Full Name | Jefferson Neurology, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 822 Pine St, Mount Shasta, California |
| Authorized Official Name and Position | Zakir M Ali (OWNER) |
| Authorized Official Contact | 5414825515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Neurology, Llc Po Box 1470 Phoenix OR 97535-1470 Ph: (541) 512-0511 | Jefferson Neurology, Llc 822 Pine St Mount Shasta CA 96067-2137 Ph: (530) 926-1039 |
| NPI Number | 1114239720 |
|---|---|
| Provider Enumeration Date | 07/12/2010 |
| Last Update Date | 07/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114239720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | A88303 (California) | Primary |
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