Healthcare Provider Details

I. General information

NPI: 1689832313
Provider Name (Legal Business Name): SLEEP EXPERTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15400 FOOTHILL BLVD
SAN LEANDRO CA
94578-1009
US

IV. Provider business mailing address

PO BOX 1300
APTOS CA
95001-1300
US

V. Phone/Fax

Practice location:
  • Phone: 510-895-4240
  • Fax:
Mailing address:
  • Phone: 831-662-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG49108
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberG49108
License Number StateCA

VIII. Authorized Official

Name: JOEL YOUNGER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 831-662-2600