Provider Demographics
NPI:1265509814
Name:NORTH VALLEY SLEEP DISORDER CENTER
Entity Type:Organization
Organization Name:NORTH VALLEY SLEEP DISORDER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-361-0996
Mailing Address - Street 1:11550 INDIAN HILLS RD STE 291
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1244
Mailing Address - Country:US
Mailing Address - Phone:818-361-0996
Mailing Address - Fax:818-365-7284
Practice Address - Street 1:11550 INDIAN HILLS RD STE 291
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1244
Practice Address - Country:US
Practice Address - Phone:818-361-0996
Practice Address - Fax:818-365-7284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP14635261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA30778BMedicare ID - Type UnspecifiedSOUTHERN
CAWCP6915AMedicare ID - Type UnspecifiedSOUTHERN