MEDICARE: CENTRAL CALIFORNIA SLEEP DISORDERS CENTER, LLC

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	:	1790935872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL CALIFORNIA SLEEP DISORDERS CENTER, LLC

Provider Business Mailing Address
First Line	:	7575 N CEDAR AVE
Second Line	:	SUITE 103
City	:	FRESNO
State	:	CA
Zip	:	93720-2693
Country	:	US
Telephone Number	:	559-447-5337
Fax Number	:	559-438-5313

Provider Business Practice Location Address
First Line	:	7575 N CEDAR AVE
Second Line	:	SUITE 103
City	:	FRESNO
State	:	CA
Zip	:	93720-2693
Country	:	US
Telephone Number	:	559-447-5337
Fax Number	:	559-438-5313

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. BRET E SHERMAN
Credential	:	M.D. PHD
Telephone Number	:	559-447-5337

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	09/07/2010

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