Provider Demographics
NPI:1255359378
Name:PULMONARY MEDICINE ASSOCIATES SLEEP LAB INC.
Entity type:Organization
Organization Name:PULMONARY MEDICINE ASSOCIATES SLEEP LAB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:EFSTRATIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-679-3524
Mailing Address - Street 1:1300 ETHAN WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2296
Mailing Address - Country:US
Mailing Address - Phone:916-679-3524
Mailing Address - Fax:916-488-7432
Practice Address - Street 1:1508 ALHAMBRA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6510
Practice Address - Country:US
Practice Address - Phone:916-325-1040
Practice Address - Fax:916-451-1141
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PULMONARY MEDICINE ASSOCIATES MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ25425ZMedicare PIN