Healthcare Provider Details
I. General information
NPI: 1124886916
Provider Name (Legal Business Name): ELITE SLEEP APNEA SOLUTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10066 ARROW RTE
RANCHO CUCAMONGA CA
91730-4194
US
IV. Provider business mailing address
10066 ARROW RTE
RANCHO CUCAMONGA CA
91730-4194
US
V. Phone/Fax
- Phone: 844-732-8475
- Fax:
- Phone: 844-732-8475
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ADRIAN
MOBILIA
Title or Position: OWNER
Credential: DDS
Phone: 844-732-8475