Provider Demographics
NPI:1700647476
Name:SIERRA FAMILY MEDICAL GROUP CORP
Entity Type:Organization
Organization Name:SIERRA FAMILY MEDICAL GROUP CORP
Other - Org Name:SIERRA ALLERGY ASTHMA AND SINUS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-259-8788
Mailing Address - Street 1:5043 E KINGS CANYON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-3962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5043 E KINGS CANYON ROAD
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-3962
Practice Address - Country:US
Practice Address - Phone:559-369-4421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty