Provider Demographics
NPI:1700124849
Name:FRESNO SLEEP WAKE CENTER INC,
Entity type:Organization
Organization Name:FRESNO SLEEP WAKE CENTER INC,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:ROPER
Authorized Official - Suffix:
Authorized Official - Credentials:06/1988
Authorized Official - Phone:559-369-4486
Mailing Address - Street 1:7005 N MILBURN AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-2161
Mailing Address - Country:US
Mailing Address - Phone:559-369-4486
Mailing Address - Fax:559-369-4492
Practice Address - Street 1:7005 N MILBURN AVE
Practice Address - Street 2:STE 201
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-2161
Practice Address - Country:US
Practice Address - Phone:559-369-4486
Practice Address - Fax:559-369-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG68242173F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty