Provider Demographics
NPI:1558421297
Name:SOUTH SACRAMENTO NEUROLOGY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:SOUTH SACRAMENTO NEUROLOGY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FIRDOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:916-837-0965
Mailing Address - Street 1:FIRDOS SHEIKH
Mailing Address - Street 2:P O BOX 649
Mailing Address - City:WILTON
Mailing Address - State:CA
Mailing Address - Zip Code:95693
Mailing Address - Country:US
Mailing Address - Phone:916-681-2226
Mailing Address - Fax:916-681-2241
Practice Address - Street 1:9381 EAST STOCKTON BLVD
Practice Address - Street 2:124 AND 222
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624
Practice Address - Country:US
Practice Address - Phone:916-681-2226
Practice Address - Fax:916-681-2241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA507042084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A507041Medicaid
CAF89741Medicare UPIN
CA00A507041Medicaid