Healthcare Provider Details
I. General information
NPI: 1821119611
Provider Name (Legal Business Name): VALLEY REGIONAL SLEEP DISORDERS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2007
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1177 E WARNER AVE
FRESNO CA
93710-4030
US
IV. Provider business mailing address
3450 W CENTRAL AVE SUITE 118
TOLEDO OH
43606-1416
US
V. Phone/Fax
- Phone: 559-431-4204
- Fax:
- Phone: 419-535-9282
- Fax: 419-535-9443
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROBERT
H
DRAGER
Title or Position: SEC. TREASURER
Credential:
Phone: 419-535-9282