MEDICARE: VISION NEUROLOGY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician
2	207WX0109X	Neuro-ophthalmology Physician

General Provider Information

NPI Number	:	1730896028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION NEUROLOGY INC.

Provider Business Mailing Address
First Line	:	582 MARKET ST STE 717
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-5308
Country	:	US
Telephone Number	:	415-800-4178
Fax Number	:	415-800-4942

Provider Business Practice Location Address
First Line	:	582 MARKET ST STE 717
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-5308
Country	:	US
Telephone Number	:	415-800-4178
Fax Number	:	415-800-4942

Authorized Official
Title or Position	:	CEO
Name	:	DR. SHAHNAZ MIRI
Credential	:	MD
Telephone Number	:	415-800-4178

Provider Enumeration Date	:	11/04/2022
Last Update Date	:	05/14/2026

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Directions to “VISION NEUROLOGY INC. ” Practice Location

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