MEDICARE: TARA NADER

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	173F00000X	Sleep Specialist (PhD)

General Provider Information

NPI Number	:	1619306693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA NADER

Provider Business Mailing Address
First Line	:	14981 NATIONAL AVE
Second Line	:	SUITE 1
City	:	LOS GATOS
State	:	CA
Zip	:	95032-2600
Country	:	US
Telephone Number	:	866-887-6673
Fax Number	:	866-442-7632

Provider Business Practice Location Address
First Line	:	225 SPRUCE AVE
Second Line	:	SUITE 1
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-3631
Country	:	US
Telephone Number	:	866-887-6673
Fax Number	:	866-442-7632

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2013
Last Update Date	:	11/11/2013

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Directions to “ TARA NADER ” Practice Location

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