Provider Demographics
NPI:1679520241
Name:CALIFORNIA SLEEP SOLUTIONS, LLC
Entity type:Organization
Organization Name:CALIFORNIA SLEEP SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-789-0112
Mailing Address - Street 1:1130 CONROY LANE
Mailing Address - Street 2:600
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4153
Mailing Address - Country:US
Mailing Address - Phone:916-789-0112
Mailing Address - Fax:916-789-0529
Practice Address - Street 1:1130 CONROY LN STE 403
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4153
Practice Address - Country:US
Practice Address - Phone:916-789-0112
Practice Address - Fax:916-789-0529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QS1200X
CA45325332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03007ZOtherBLUE SHIELD
CAZZZ13123ZOtherBLUE SHIELD
CAZZZ13125ZOtherBLUE SHIELD
CAZZZ13124ZOtherBLUE SHIELD
CAZZZ13124ZOtherBLUE SHIELD
CAZZZ13123ZOtherBLUE SHIELD
CAZZZ03007ZOtherBLUE SHIELD
CA4435620001Medicare NSC
CAZZZ13125ZOtherBLUE SHIELD