MEDICARE: SLEEPQUEST MEDICAL ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1154442739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEPQUEST MEDICAL ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	975 INDUSTRIAL RD STE G
Second Line	:
City	:	SAN CARLOS
State	:	CA
Zip	:	94070-4138
Country	:	US
Telephone Number	:	650-412-0123
Fax Number	:	650-412-0124

Provider Business Practice Location Address
First Line	:	975 INDUSTRIAL RD STE G
Second Line	:
City	:	SAN CARLOS
State	:	CA
Zip	:	94070-4138
Country	:	US
Telephone Number	:	650-412-0123
Fax Number	:	650-412-0124

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	MARY L ORTALDA
Credential	:
Telephone Number	:	650-412-0125

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	10/30/2020

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