Healthcare Provider Details

I. General information

NPI: 1093319873
Provider Name (Legal Business Name): CARE SLEEP CLINIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2020
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 GRAVES AVE STE 11F
SAN JOSE CA
95129-5014
US

IV. Provider business mailing address

1027 CORVETTE DR
SAN JOSE CA
95129-2904
US

V. Phone/Fax

Practice location:
  • Phone: 408-930-5238
  • Fax: 408-564-7468
Mailing address:
  • Phone: 408-835-8213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LUBNA AZEEM
Title or Position: OWNER
Credential: DDS
Phone: 408-835-8213