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NPI Code Detail

MEDICARE: PACIFIC SLEEP MEDICINE, A MEDICAL CORPORATION

MEDICARE: PACIFIC SLEEP MEDICINE, A MEDICAL CORPORATION
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
1174400000XSpecialist

General Provider Information

NPI Number : 1548405145
Entity Type Code : Organization
Provider Name (Legal Business Name) : PACIFIC SLEEP MEDICINE, A MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 104 E OLIVE AVE
Second Line : STE 104
City : REDLANDS
State : CA
Zip : 92373-5255
Country : US
Telephone Number : 909-793-9190
Fax Number : 909-793-9770
Provider Business Practice Location Address
First Line : 555 WASHINGTON ST
Second Line : STE 1037
City : SAN DIEGO
State : CA
Zip : 92103-2289
Country : US
Telephone Number : 619-293-0874
Fax Number : 619-293-3403
Authorized Official
Title or Position : CREDENTIALING
Name : MRS. REBECCA M BOJORQUEZ
Credential :
Telephone Number : 909-793-9190
Provider Enumeration Date : 12/10/2008
Last Update Date : 02/04/2011

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Directions to “PACIFIC SLEEP MEDICINE, A MEDICAL CORPORATION ” Practice Location

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