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General NPI Number Information
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NPI Number | 1831330729
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Entity Type | Organization
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Legal Business Name | NORTH COUNTY OPHTHALMOLOGY MEDICAL GROUP
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Dates
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Enumeration Date | 03/23/2009
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 15708 POMERADO RD SUITE-N-202
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City | POWAY
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State | CA
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Zip | 92064-2066
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Country | US
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Telephone | 858-485-5600
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Fax | 858-485-5692
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Provider Business Mailing Address
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Address Line | 15708 POMERADO RD SUITE-N-202
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City | POWAY
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State | CA
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Zip | 92064-2066
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Country | US
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Telephone | 858-485-5600
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Fax | 858-485-5692
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Authorized Official
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Title or Position | OWNER
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Name | DR. PARAS R SHAH
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Credential | MD
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Telephone | 858-485-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A100573
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License Number State | CA
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