MEDICARE: SINA. INC

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	2084V0102X	Vascular Neurology Physician	42963	AZ

General Provider Information

NPI Number	:	1285087528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINA. INC

Provider Business Mailing Address
First Line	:	9326 N CHOLLA PL
Second Line	:
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-1808
Country	:	US
Telephone Number	:	480-381-8398
Fax Number	:	480-393-3401

Provider Business Practice Location Address
First Line	:	9326 N CHOLLA PL
Second Line	:
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-1808
Country	:	US
Telephone Number	:	480-381-8398
Fax Number	:	480-393-3401

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	DR. AHMED ESSAM EL-GENGAIHY
Credential	:	M.D
Telephone Number	:	480-381-8398

Provider Enumeration Date	:	07/21/2016
Last Update Date	:	07/21/2016

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