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General NPI Number Information
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NPI Number | 1841474822
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Entity Type | Organization
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Legal Business Name | NORTH ORANGE COUNTY SLEEP CLINIC MEDICAL GROUP INC
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Dates
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Enumeration Date | 12/26/2007
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 1915 SUNNYCREST DR
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City | FULLERTON
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State | CA
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Zip | 92835-3626
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Country | US
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Telephone | 714-446-7240
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Fax | 714-446-7245
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Provider Business Mailing Address
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Address Line | PO BOX 1449
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City | BREA
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State | CA
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Zip | 92822-1449
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Country | US
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Telephone | 714-996-1633
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Fax | 714-996-9267
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOUIS J MCNABB
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Credential | M.D.
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Telephone | 714-446-7454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY5096
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | C38832
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | G36837
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License Number State | CA
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