Southern California Neurology And Psychiatry | |
4275 Executive Sq Ste 200 La Jolla CA 92037-1476 | |
(619) 403-1701 | |
(619) 810-2863 |
Full Name | Southern California Neurology And Psychiatry |
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Speciality | Psychiatry & Neurology - Neurology |
Location | 4275 Executive Sq Ste 200, La Jolla, California |
Authorized Official Name and Position | Panna Ramanlal Shah (PHYSICIAN) |
Authorized Official Contact | 6194031701 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southern California Neurology And Psychiatry 1212 San Dieguito Dr Encinitas CA 92024-5115 Ph: (619) 403-1701 | Southern California Neurology And Psychiatry 4275 Executive Sq Ste 200 La Jolla CA 92037-1476 Ph: (619) 403-1701 |
NPI Number | 1114271665 |
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Provider Enumeration Date | 11/06/2012 |
Last Update Date | 11/06/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114271665 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | C53290 (California) | Primary |
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