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General NPI Number Information
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NPI Number | 1457298374
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Entity Type | Organization
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Legal Business Name | PRIVATE MEDICAL CONNECTICUT PC
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 50 OLD FIELD POINT RD FL 3
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City | GREENWICH
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State | CT
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Zip | 06830-6157
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Country | US
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Telephone | 203-489-7333
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Fax |
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Provider Business Mailing Address
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Address Line | 3580 CALIFORNIA ST STE 101
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1716
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Country | US
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Telephone | 415-830-3090
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER/OWNER
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Name | JORDAN SHLAIN
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Credential | MD
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Telephone | 415-830-3090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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