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General NPI Number Information
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NPI Number | 1518527613
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Entity Type | Organization
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Legal Business Name | NEUROGUARD PRO
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 795 S QUAIL CIR
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City | ANAHEIM
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State | CA
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Zip | 92807-4427
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Country | US
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Telephone | 949-338-5939
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1013
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City | SAN RAMON
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State | CA
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Zip | 94583-1013
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Country | US
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Telephone | 949-338-5939
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Fax |
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Authorized Official
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Title or Position | BILLING OFFICE MANAGER
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Name | SHERRI BURNINGHAM
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Credential |
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Telephone | 707-953-0956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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