Provider Demographics
NPI:1619192861
Name:ADVANCED PULMONARY, SLEEP DISORDER AND INTERNAL MEDICINE,LLC
Entity Type:Organization
Organization Name:ADVANCED PULMONARY, SLEEP DISORDER AND INTERNAL MEDICINE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZAHABIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-688-7770
Mailing Address - Street 1:640 E 700 S
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4023
Mailing Address - Country:US
Mailing Address - Phone:435-688-7770
Mailing Address - Fax:
Practice Address - Street 1:640 E 700 S
Practice Address - Street 2:SUITE 105
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4023
Practice Address - Country:US
Practice Address - Phone:435-688-7770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-14
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT00014102261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty