Provider Demographics
NPI:1104940121
Name:RENAISSANCE SLEEP CENTER, INC
Entity type:Organization
Organization Name:RENAISSANCE SLEEP CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GAGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-322-6900
Mailing Address - Street 1:PO BOX 28381
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-8381
Mailing Address - Country:US
Mailing Address - Phone:559-322-6900
Mailing Address - Fax:559-322-6977
Practice Address - Street 1:7065 N CHESTNUT AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0355
Practice Address - Country:US
Practice Address - Phone:559-322-6900
Practice Address - Fax:559-322-6977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ28878ZMedicare UPIN