Provider Demographics
NPI:1932137007
Name:FRESNO SLEEP-WAKE DISORDER CENTER OF CALIFORNIA, INC.
Entity Type:Organization
Organization Name:FRESNO SLEEP-WAKE DISORDER CENTER OF CALIFORNIA, INC.
Other - Org Name:SLEEP/WAKE DISORDERS CENTER FRESNO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKUME
Authorized Official - Suffix:
Authorized Official - Credentials:RCP, RPSGT
Authorized Official - Phone:559-367-1058
Mailing Address - Street 1:6073 NORTH FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5444
Mailing Address - Country:US
Mailing Address - Phone:559-436-9600
Mailing Address - Fax:559-436-9606
Practice Address - Street 1:6073 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5444
Practice Address - Country:US
Practice Address - Phone:559-436-9600
Practice Address - Fax:559-436-9606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31895ZMedicare PIN
ZZZ31895ZMedicare UPIN
ZZZ31895ZMedicare Oscar/Certification