Provider Demographics
NPI:1770882946
Name:QUALIUM CORP
Entity type:Organization
Organization Name:QUALIUM CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANOOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSTOWFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-499-7597
Mailing Address - Street 1:14981 NATIONAL AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2600
Mailing Address - Country:US
Mailing Address - Phone:866-887-6673
Mailing Address - Fax:866-442-7632
Practice Address - Street 1:950 CASS ST
Practice Address - Street 2:SUITE C
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4546
Practice Address - Country:US
Practice Address - Phone:831-655-3554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUALIUM CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-27
Last Update Date:2011-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic