Healthcare Provider Details

I. General information

NPI: 1932298247
Provider Name (Legal Business Name): NORTH STATE SLEEP LAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 INDEPENDENCE CIR SUITE 1
CHICO CA
95973-4918
US

IV. Provider business mailing address

130 INDEPENDENCE CIR SUITE 1
CHICO CA
95973-4918
US

V. Phone/Fax

Practice location:
  • Phone: 530-343-5864
  • Fax: 530-343-8370
Mailing address:
  • Phone: 530-343-5864
  • Fax: 530-343-8370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN VRBETA
Title or Position: CO-OWNER
Credential: RT
Phone: 530-343-5864