Flagstaff Neurology

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

33297 Issued in AZ

Legal business name

FLAGSTAFF NEUROLOGY

Practice address

4275 Executive SQ Ste 200
La Jolla, CA 92037-1476

Phone

(619) 403-1701

NPI assigned

Feb 27, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Panna Shah, MD

Title

Physiccian Owner

Phone

(619) 403-1701

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1518136241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 N HUMPHREYS ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013024",
            "telephone_number": "928-774-2459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 EXECUTIVE SQ STE 200",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371476",
            "telephone_number": "619-403-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGSTAFF NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2012-08-21",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PANNA",
        "authorized_official_title_or_position": "PHYSICCIAN OWNER",
        "authorized_official_telephone_number": "619-403-1701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "33297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bahrom Firozgary, MD
• Jonathan S. Fisher, M.D.
• Kirsten Lynn Fisher, M.D.
• Leland Joseph Fitzgerald, D.D.S.
• Carmella Louise Fitzpatrick, LVN
• Liam Flanagan, MD
• Adam Fleisher, M.D.
• Jill Catherine Fleming, MFT
• Eden Fletcher, PA-C
• Arnold Leab Flick, M.D.

• Neurology Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.