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General NPI Number Information
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NPI Number | 1619136843
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Entity Type | Organization
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Legal Business Name | CALIFORNIA COAST CARE SLEEP CENTER INC
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 999 N TUSTIN AVE SUITE 17A
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City | SANTA ANA
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State | CA
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Zip | 92705-3528
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Country | US
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Telephone | 949-395-0795
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Fax |
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Provider Business Mailing Address
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Address Line | 999 N TUSTIN AVE SUITE 17A
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City | SANTA ANA
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State | CA
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Zip | 92705-3528
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Country | US
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Telephone | 949-395-0795
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NATALIA BAKOULINA
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Credential |
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Telephone | 949-395-0795
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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 |
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License Number State |
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