Healthcare Provider Details

I. General information

NPI: 1992050165
Provider Name (Legal Business Name): BAKERSFIELD SLEEP CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 01/17/2024
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 EASTON DR STE 110
BAKERSFIELD CA
93309-9403
US

IV. Provider business mailing address

1400 EASTON DR STE 110
BAKERSFIELD CA
93309-9403
US

V. Phone/Fax

Practice location:
  • Phone: 661-873-4911
  • Fax:
Mailing address:
  • Phone: 661-873-4911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number3485606
License Number StateCA

VIII. Authorized Official

Name: ROSE MAESTAS
Title or Position: CFO
Credential:
Phone: 661-805-0701