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General NPI Number Information
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NPI Number | 1861134785
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Entity Type | Organization
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Legal Business Name | HAIDER SHAHID MD PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 277 SOUTH ST., SUITE V
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401
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Country | US
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Telephone | 805-439-6575
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Fax | 805-850-3305
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Provider Business Mailing Address
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Address Line | 277 SOUTH ST., SUITE V
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401
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Country | US
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Telephone | 805-439-6575
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Fax | 805-850-3305
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MR. HAIDER SHAHID
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Credential | M.D.
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Telephone | 805-439-6575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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