Provider Demographics
NPI:1023465986
Name:JAGGI, SHAAN (MD)
Entity type:Individual
Prefix:DR
First Name:SHAAN
Middle Name:
Last Name:JAGGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11485 MONTE ISOLA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3319
Mailing Address - Country:US
Mailing Address - Phone:269-779-6600
Mailing Address - Fax:
Practice Address - Street 1:3835 S JONES BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2283
Practice Address - Country:US
Practice Address - Phone:702-880-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV21214207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine