Provider Demographics
NPI:1316277213
Name:PULMONARY AND SLEEP ASSOCIATES OF CALIFORNIA, INC
Entity type:Organization
Organization Name:PULMONARY AND SLEEP ASSOCIATES OF CALIFORNIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:ARSHOD
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-609-8513
Mailing Address - Street 1:137 SAN JOSE CT
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3560
Mailing Address - Country:US
Mailing Address - Phone:415-609-8513
Mailing Address - Fax:707-689-5639
Practice Address - Street 1:1200 B GALE WILSON BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533
Practice Address - Country:US
Practice Address - Phone:818-522-2358
Practice Address - Fax:951-272-9924
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PULMONARY AND SLEEP ASSOCIATES OF CA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-28
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56269207RC0200X, 207RP1001X, 207RS0012X
207RP1001X, 207RS0012X
CAA056269207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA56269OtherCALIFORNIA STATE LICENSE
CA1316277213OtherPTAN CJ207X