Healthcare Provider Details

I. General information

NPI: 1689439911
Provider Name (Legal Business Name): LODHI MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
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

9515 E FOWLER AVE STE 241
THONOTOSASSA FL
33592-2139
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAFI ALI KHAN LODHI
Title or Position: PRESIDENT
Credential: MD
Phone: 650-248-2467