Provider Demographics
NPI:1295975274
Name:CENTRAL CALIFORNIA SLEEP CENTER
Entity type:Organization
Organization Name:CENTRAL CALIFORNIA SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WELDON
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHAPANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-577-6673
Mailing Address - Street 1:4269 N WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-3627
Mailing Address - Country:US
Mailing Address - Phone:559-577-6673
Mailing Address - Fax:559-456-8814
Practice Address - Street 1:7770 N FRESNO ST STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2412
Practice Address - Country:US
Practice Address - Phone:559-577-6673
Practice Address - Fax:559-456-8814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21507208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6174790001Medicare NSC
CA1588683692Medicare UPIN