Provider Demographics
NPI:1700830783
Name:FREMONT SLEEP APNEA CENTER, LLC
Entity Type:Organization
Organization Name:FREMONT SLEEP APNEA CENTER, LLC
Other - Org Name:SLEEP DIAGNOSTICS OF FREMONT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARBJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:DHESI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-742-9143
Mailing Address - Street 1:556 MOWRY AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-4186
Mailing Address - Country:US
Mailing Address - Phone:510-742-5432
Mailing Address - Fax:510-742-8767
Practice Address - Street 1:556 MOWRY AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4186
Practice Address - Country:US
Practice Address - Phone:510-742-5432
Practice Address - Fax:510-742-8767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5468261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ05021ZMedicare PIN
CAU72576Medicare UPIN