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General NPI Number Information
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NPI Number | 1225559255
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Entity Type | Organization
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Legal Business Name | C2C MEDICAL APC/C2C SLEEP
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8816 FOOTHILL BLVD STE 103
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730
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Country | US
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Telephone | 213-349-1449
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Fax |
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Provider Business Mailing Address
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Address Line | 8816 FOOTHILL BLVD STE 103
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7199
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Country | US
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Telephone | 213-349-1449
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GURDIP SINGH FLORA
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Credential | MD
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Telephone | 213-349-1449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | A43194
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License Number State | CA
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