Provider Demographics
NPI:1821150491
Name:HIGH DESERT SLEEP DISORDER CENTER
Entity Type:Organization
Organization Name:HIGH DESERT SLEEP DISORDER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VERMEULEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-242-2221
Mailing Address - Street 1:16017 TUSCOLA ROAD SUITE C
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1317
Mailing Address - Country:US
Mailing Address - Phone:760-242-2221
Mailing Address - Fax:
Practice Address - Street 1:16017 TUSCOLA ROAD SUITE C
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1317
Practice Address - Country:US
Practice Address - Phone:760-242-2221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic