Healthcare Provider Details

I. General information

NPI: 1154019446
Provider Name (Legal Business Name): VALLEY SLEEP AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 04/26/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 E HERNDON AVE STE 102
FRESNO CA
93720-3346
US

IV. Provider business mailing address

1660 E HERNDON AVE STE 102
FRESNO CA
93720-3346
US

V. Phone/Fax

Practice location:
  • Phone: 559-840-2262
  • Fax:
Mailing address:
  • Phone: 559-840-2262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: UMAR B NASIR
Title or Position: MEDICAL DIRECTOR/ PRESIDENT
Credential: MD
Phone: 732-372-5513