| Gobran Shahla Md Pllc | |
|
9139 W Thunderbird Rd Ste 275 Peoria AZ 85381-4922 | |
| (623) 900-5181 | |
| Not Available |
| Full Name | Gobran Shahla Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9139 W Thunderbird Rd Ste 275, Peoria, Arizona |
| Authorized Official Name and Position | Gobran Shahla (OWNER) |
| Authorized Official Contact | 6239005181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gobran Shahla Md Pllc 25255 N 44th Dr Phoenix AZ 85083-1690 Ph: (480) 341-0003 | Gobran Shahla Md Pllc 9139 W Thunderbird Rd Ste 275 Peoria AZ 85381-4922 Ph: (623) 900-5181 |
| NPI Number | 1881441681 |
|---|---|
| Provider Enumeration Date | 05/01/2024 |
| Last Update Date | 05/01/2024 |
| Medicare PECOS PAC ID | 7214379197 |
|---|---|
| Medicare Enrollment ID | O20240523000977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881441681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gobran Shahla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649694720 PECOS PAC ID: 6103047816 Enrollment ID: I20141022001115 |
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