# SAN ANDREAS SLEEP DISORDERS MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** San Andreas Sleep Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457603664
- **Authorized official:** STACY ANN JOYNER (OFFICE MANAGER)
- **Authorized official phone:** (209) 754-5374

## Contact information

- **Practice address:** 704 MOUNTAIN RANCH RD, SUITE 205, SAN ANDREAS, CA 95249-9707
- **Practice address phone:** (209) 754-5374
- **Practice address fax:** (209) 754-5376
- **Mailing address:** 704 MOUNTAIN RANCH RD, SUITE 205, SAN ANDREAS, CA 95249-9707
- **Mailing address phone:** (209) 754-5374
- **Mailing address fax:** (209) 754-5376

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | A45770 | CA | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | A101134 | CA | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | A45770 | CA | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | A56143 | CA | — |

## Other

- **Enumeration date:** 10/11/2012
- **Last updated:** 12/24/2013