Healthcare Provider Details

I. General information

NPI: 1255420329
Provider Name (Legal Business Name): ADVANCED RESPIRATORY AND SLEEP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N BASCOM AVE STE 202
SAN JOSE CA
95128-1811
US

IV. Provider business mailing address

105 N BASCOM AVE STE 202
SAN JOSE CA
95128-1811
US

V. Phone/Fax

Practice location:
  • Phone: 408-993-1500
  • Fax: 408-993-1521
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License NumberA070405
License Number StateCA

VIII. Authorized Official

Name: JYOTI CHALLI
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 650-766-9338