Healthcare Provider Details

I. General information

NPI: 1851410864
Provider Name (Legal Business Name): SLEEPMED OF CALIFORNIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N HILL AVE STE 206
PASADENA CA
91106-1934
US

IV. Provider business mailing address

99 ROSEWOOD DR STE 245
DANVERS MA
01923-4537
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-3033
  • Fax:
Mailing address:
  • Phone: 978-536-7400
  • Fax: 978-535-9778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JANICE SHOCK
Title or Position: EVP CLINICAL OPERATIONS
Credential:
Phone: 214-532-3757