Provider Demographics
NPI:1558393686
Name:SIERRA REHABILITATION MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:SIERRA REHABILITATION MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:IMAH
Authorized Official - Middle Name:MOHAMES
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:916-784-7506
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-0685
Mailing Address - Country:US
Mailing Address - Phone:916-784-7500
Mailing Address - Fax:916-784-6319
Practice Address - Street 1:1421 SECRET RAVINE PKWY
Practice Address - Street 2:STE 111
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661
Practice Address - Country:US
Practice Address - Phone:916-784-7500
Practice Address - Fax:916-784-6319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ01388ZMedicare ID - Type Unspecified