Provider Demographics
NPI:1932925500
Name:SGA, LLC
Entity type:Organization
Organization Name:SGA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUMAIRA
Authorized Official - Middle Name:GUL
Authorized Official - Last Name:MUSHTAQ
Authorized Official - Suffix:
Authorized Official - Credentials:ED D, MS, CCC-SLP
Authorized Official - Phone:510-449-2092
Mailing Address - Street 1:46985 LUNDY TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-7050
Mailing Address - Country:US
Mailing Address - Phone:510-449-2092
Mailing Address - Fax:
Practice Address - Street 1:46985 LUNDY TER
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7050
Practice Address - Country:US
Practice Address - Phone:510-449-2092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-28
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty