Provider Demographics
NPI:1982368528
Name:SIERRA NEURODIAGNOSTIC GROUP LLC
Entity type:Organization
Organization Name:SIERRA NEURODIAGNOSTIC GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MASROOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SARWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-372-7527
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551
Mailing Address - Country:US
Mailing Address - Phone:510-372-7527
Mailing Address - Fax:
Practice Address - Street 1:299 EAST WARREN AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539
Practice Address - Country:US
Practice Address - Phone:510-372-7527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty