Healthcare Provider Details

I. General information

NPI: 1922539337
Provider Name (Legal Business Name): SHAFI ALI KHAN LODHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 MARKET ST STE 341
SAN FRANCISCO CA
94102-3022
US

IV. Provider business mailing address

7151 OKELLY CHAPEL RD STE 270
CARY NC
27519-6849
US

V. Phone/Fax

Practice location:
  • Phone: 650-248-2467
  • Fax: 855-452-6817
Mailing address:
  • Phone: 650-789-1865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberA170954
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: