Gobran Shahla MD PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GOBRAN SHAHLA MD PLLC

Practice address

9139 W Thunderbird Rd Ste 275
Peoria, AZ 85381-4922

Phone

(623) 900-5181

NPI assigned

May 1, 2024

Organization subpart

No

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

Authorized official

Name

Gobran Shahla, MDNPI 1649694720

Title

Owner

Phone

(623) 900-5181

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gobran Shahla

  • Internal Medicine Physician
  • Peoria, AZ
  • NPI 1649694720
  Medicare reassignment NPD Authorized official
• Ashwini Nayak Ammunje, M.D.

  • Internal Medicine Physician
  • Peoria, AZ
  • NPI 1891088563
  NPD (past)

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1881441681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25255 N 44TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850831690",
            "telephone_number": "480-341-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9139 W THUNDERBIRD RD STE 275",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814922",
            "telephone_number": "623-900-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOBRAN SHAHLA MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "SHAHLA",
        "authorized_official_first_name": "GOBRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-900-5181",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.