Provider Demographics
NPI:1255632550
Name:BAY AREA SLEEP MEDICINE
Entity type:Organization
Organization Name:BAY AREA SLEEP MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WEI
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-216-8763
Mailing Address - Street 1:2504 SAMARITAN DRIVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4005
Mailing Address - Country:US
Mailing Address - Phone:408-216-8763
Mailing Address - Fax:408-416-3706
Practice Address - Street 1:2504 SAMARITAN DRIVE
Practice Address - Street 2:SUITE 10
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4005
Practice Address - Country:US
Practice Address - Phone:408-216-8763
Practice Address - Fax:408-416-3706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA914182084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty