Provider Demographics
NPI:1902256043
Name:WEST BAY SLEEP DIAGNOSTICS INC
Entity Type:Organization
Organization Name:WEST BAY SLEEP DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EVANGELINE
Authorized Official - Middle Name:BRADY
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-829-2446
Mailing Address - Street 1:91 WESTBOROUGH BLVD STE 1020
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-3162
Mailing Address - Country:US
Mailing Address - Phone:650-829-2446
Mailing Address - Fax:650-829-2446
Practice Address - Street 1:91 WESTBOROUGH BLVD STE 1020
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-3162
Practice Address - Country:US
Practice Address - Phone:650-829-2446
Practice Address - Fax:650-829-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA175829291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory