Healthcare Provider Details

I. General information

NPI: 1679520241
Provider Name (Legal Business Name): CALIFORNIA SLEEP SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 CONROY LN STE 403
ROSEVILLE CA
95661-4153
US

IV. Provider business mailing address

1130 CONROY LANE 600
ROSEVILLE CA
95661-4153
US

V. Phone/Fax

Practice location:
  • Phone: 916-789-0112
  • Fax: 916-789-0529
Mailing address:
  • Phone: 916-789-0112
  • Fax: 916-789-0529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number45325
License Number StateCA

VIII. Authorized Official

Name: WADE A WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 916-789-0112