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General NPI Number Information
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NPI Number | 1871081380
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Entity Type | Organization
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Legal Business Name | CALIFORNIA SLEEP PHYSICIANS MEDICAL GROUP INC
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 1130 CONROY LN STE 500
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City | ROSEVILLE
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State | CA
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Zip | 95661-4153
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Country | US
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Telephone | 916-789-0112
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Fax | 916-789-0529
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Provider Business Mailing Address
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Address Line | 1130 CONROY LN STE 600
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City | ROSEVILLE
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State | CA
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Zip | 95661-4153
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Country | US
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Telephone | 916-789-0112
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANNETTE CHIHOREK
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Credential | MD
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Telephone | 916-789-0112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 93606
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License Number State | CA
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