1841474822 NPI number — NORTH ORANGE COUNTY SLEEP CLINIC MEDICAL GROUP INC

Table of content: (NPI 1841474822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841474822 NPI number — NORTH ORANGE COUNTY SLEEP CLINIC MEDICAL GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH ORANGE COUNTY SLEEP CLINIC MEDICAL GROUP INC
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:
1841474822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1449
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BREA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92822-1449
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-996-1633
Provider Business Mailing Address Fax Number:
714-996-9267

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1915 SUNNYCREST DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FULLERTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92835-3626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-446-7240
Provider Business Practice Location Address Fax Number:
714-446-7245
Provider Enumeration Date:
12/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCNABB
Authorized Official First Name:
LOUIS
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
714-446-7454

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY5096 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084S0012X , with the licence number: C38832 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084S0012X , with the licence number: G36837 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1346329323 . This is a "DR. MCNABB NPI" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1730264912 . This is a "DR. PETRIE NPI NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1083898043 . This is a "DR. WHITE NPI NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".