MEDICARE: GUARANTEED HEALTH MEDICAL GROUP WEST PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1578443412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARANTEED HEALTH MEDICAL GROUP WEST PC

Provider Business Mailing Address
First Line	:	2445 AUGUSTINE DR
Second Line	:	150 AND 201
City	:	SANTA CLARA
State	:	CA
Zip	:	95054-3032
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2445 AUGUSTINE DR STE 150
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95054-3032
Country	:	US
Telephone Number	:	720-434-3556
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SINA HAERI
Credential	:	MD
Telephone Number	:	410-814-1872

Provider Enumeration Date	:	09/03/2025
Last Update Date	:	09/23/2025

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