=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841659117
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SLEEP & CPAP CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2016
-----------------------------------------------------
Last Update Date | 02/16/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 MAGNOLIA AVENUE SUITE 101
-----------------------------------------------------
City | CORONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92879
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-824-6002
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16573 JACKSON CT
-----------------------------------------------------
City | FONTANA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92336-2052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MRS. KRISTI CERRILLO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 626-824-6002
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------