1447526405 NPI number — TSK SLEEP LLC

Table of content: WILLIAM A. RECORDS D.D.S. (NPI 1265584528)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447526405 NPI number — TSK SLEEP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TSK SLEEP LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447526405
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2655 PARK CENTER DR
Provider Second Line Business Mailing Address:
UNIT C
Provider Business Mailing Address City Name:
SIMI VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93065-6277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-497-2171
Provider Business Mailing Address Fax Number:
888-376-2141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2655 PARK CENTER DR
Provider Second Line Business Practice Location Address:
UNIT C
Provider Business Practice Location Address City Name:
SIMI VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93065-6277
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-497-2171
Provider Business Practice Location Address Fax Number:
888-376-2141
Provider Enumeration Date:
03/23/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KAPLAN
Authorized Official First Name:
TODD
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
805-497-2171

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)