Organization
MONTEREY BAY SLEEP CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN KOOSTRA MD (PARTNER)
(831) 920-1411
Entity
Organization
Contact information
Practice address
60 GARDEN COURT SUITE 250, MONTEREY, CA 93940
(831) 920-1411
(831) 920-1452
Mailing address
60 GARDEN COURT SUITE 250, MONTEREY, CA 93940
(831) 920-1411
(831) 920-1452
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
261QS12000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XXXX
PENDING
CA
Enumeration date
07/18/2015
Last updated
07/30/2015
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