Provider Demographics
NPI:1932298247
Name:NORTH STATE SLEEP LAB
Entity Type:Organization
Organization Name:NORTH STATE SLEEP LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:VRBETA
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:530-343-5864
Mailing Address - Street 1:130 INDEPENDENCE CIR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-4918
Mailing Address - Country:US
Mailing Address - Phone:530-343-5864
Mailing Address - Fax:530-343-8370
Practice Address - Street 1:130 INDEPENDENCE CIR
Practice Address - Street 2:SUITE 1
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4918
Practice Address - Country:US
Practice Address - Phone:530-343-5864
Practice Address - Fax:530-343-8370
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH STATE PULMONARY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-12
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ24447ZMedicare ID - Type Unspecified