Healthcare Provider Details
I. General information
NPI: 1700830783
Provider Name (Legal Business Name): FREMONT SLEEP APNEA CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2006
Last Update Date: 03/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
556 MOWRY AVE SUITE 102
FREMONT CA
94536-4186
US
IV. Provider business mailing address
556 MOWRY AVE SUITE 102
FREMONT CA
94536-4186
US
V. Phone/Fax
- Phone: 510-742-5432
- Fax: 510-742-8767
- Phone: 510-742-5432
- Fax: 510-742-8767
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | 5468 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
SARBJIT
DHESI
Title or Position: PRESIDENT
Credential: D.C.
Phone: 510-742-9143