Provider Demographics
NPI:1982851929
Name:SLEEP DIAGNOSTICS OF THE COACHELLA VALLEY LLC
Entity type:Organization
Organization Name:SLEEP DIAGNOSTICS OF THE COACHELLA VALLEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSHEFSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-412-1523
Mailing Address - Street 1:PO BOX 2709
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92235-2709
Mailing Address - Country:US
Mailing Address - Phone:760-412-1523
Mailing Address - Fax:
Practice Address - Street 1:81833 DR CARREON BLVD STE 4
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5590
Practice Address - Country:US
Practice Address - Phone:760-347-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABO906Medicare PIN