| Neuroguard Pro | |
|
795 S Quail Cir Anaheim CA 92807-4427 | |
| (949) 338-5939 | |
| Not Available |
| Full Name | Neuroguard Pro |
|---|---|
| Speciality | Specialist/Technologist, Other |
| Location | 795 S Quail Cir, Anaheim, California |
| Authorized Official Name and Position | Sherri Burningham (BILLING OFFICE MANAGER) |
| Authorized Official Contact | 7079530956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuroguard Pro Po Box 1013 San Ramon CA 94583-1013 Ph: (949) 338-5939 | Neuroguard Pro 795 S Quail Cir Anaheim CA 92807-4427 Ph: (949) 338-5939 |
| NPI Number | 1518527613 |
|---|---|
| Provider Enumeration Date | 06/19/2019 |
| Last Update Date | 01/15/2026 |
| Certification Date | 01/15/2026 |
| Medicare PECOS PAC ID | 7214338581 |
|---|---|
| Medicare Enrollment ID | O20210623003424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518527613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | () | Secondary |
| 246ZE0600X | Specialist/technologist, Other - Electroneurodiagnostic | () | Primary |
| Provider Name | Dela Amoussou |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639464431 PECOS PAC ID: 0941441356 Enrollment ID: I20160907002758 |
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