Healthcare Provider Details

I. General information

NPI: 1114157047
Provider Name (Legal Business Name): CALIFORNIA SLEEP INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 07/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 UNIVERSITY AVE SUITE # 101
EAST PALO ALTO CA
94303-2212
US

IV. Provider business mailing address

1900 UNIVERSITY AVE SUITE # 101
EAST PALO ALTO CA
94303-2212
US

V. Phone/Fax

Practice location:
  • Phone: 650-494-1000
  • Fax: 650-433-5448
Mailing address:
  • Phone: 650-494-1000
  • Fax: 650-433-5448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH B ROBERSON II
Title or Position: CEO
Credential: M.D.
Phone: 650-494-1000