Provider Demographics
NPI:1821119611
Name:VALLEY REGIONAL SLEEP DISORDERS CENTER INC
Entity Type:Organization
Organization Name:VALLEY REGIONAL SLEEP DISORDERS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC. TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:DRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-535-9282
Mailing Address - Street 1:3450 W CENTRAL AVE
Mailing Address - Street 2:SUITE 118
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1416
Mailing Address - Country:US
Mailing Address - Phone:419-535-9282
Mailing Address - Fax:419-535-9443
Practice Address - Street 1:1177 E WARNER AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-4030
Practice Address - Country:US
Practice Address - Phone:559-431-4204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ17312ZMedicare ID - Type UnspecifiedIDTF