Provider Demographics
NPI:1417013020
Name:MADERA PULMONARY AND SLEEP DISORDERS
Entity Type:Organization
Organization Name:MADERA PULMONARY AND SLEEP DISORDERS
Other - Org Name:SLEEP WAKE MADERA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAZHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVAID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-673-9021
Mailing Address - Street 1:1280 E ALMOND AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5606
Mailing Address - Country:US
Mailing Address - Phone:559-673-9021
Mailing Address - Fax:559-673-6234
Practice Address - Street 1:1260 E ALMOND AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-6500
Practice Address - Country:US
Practice Address - Phone:559-673-9021
Practice Address - Fax:559-673-6234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic