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Shah, Syed Jibran

CPSO#: 120299

MEMBER STATUS

Active Member as of 02 Jan 2020

CURRENT OR PAST CPSO REGISTRATION CLASS

Independent Practice as of 28 Apr 2022

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, Urdu

Education: Touro College of Osteopathic Medicine NY, 2014

Practice Information

Primary Location of Practice

Phoenix Healthcare Centre
450 Frederick street
Suite 301
Kitchener ON N2H 2P5
Phone: (519) 748-6933 Electoral District: 03

Additional Practice Location(s)

99 Northfield Dr E
Suite 306
Waterloo ON N2K 3P9
Canada
Phone: (519) 279-1497
County: Regional Municipality of Waterloo
Electoral District: 03

Professional Corporation Information

Corporation Name: S.J. Shah Medicine Professional Corporation
Certificate of Authorization Status: Issued Date: Aug 11 2022

Shareholders:
Dr. S. Shah ( CPSO# 120299)

Business Address:
301-450 Frederick St
Kitchener ON N2H 2P5
Phone Number: 519-748-6933

Specialties

Specialty	Issued On	Type
Family Medicine	Effective:12 May 2020	CFPC Specialist

Terms and Conditions

(1) Dr. SYED JIBRAN SHAH may practise only in the areas of medicine in which Dr. SHAH is educated and experienced.

Registration History

Action	Issue Date
First certificate of registration issued: Restricted certificate	Effective: 02 Jan 2020
Terms and conditions imposed on certificate by Registration Committee	Effective: 02 Jan 2020
Expiry date attached to certificate of registration.	Expiry Date: 01 Jul 2021
Terms and conditions amended by Registration Committee	Effective: 07 May 2021
Subsequent certificate of registration Issued: Independent Practice Certificate	Effective: 28 Apr 2022