Organization
QUALIUM CORP
Active
Other names
BAY SLEEP CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANOOSH MOSTOWFI (PRESIDENT)
(408) 499-7597
Entity
Organization
Contact information
Practice address
14981 NATIONAL AVE, SUITE 1, LOS GATOS, CA 95032-2600
(866) 887-6673
(408) 358-7753
Mailing address
14981 NATIONAL AVE, SUITE 1, LOS GATOS, CA 95032-2600
(866) 887-6673
(408) 358-7753
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7383382
AETNA ID#
CA
01
—
P00310625
RAILROAD MEDICARE ID#
CA
01
—
ZZZ03726Z
BLUE SHIELD ID#
CA
01
—
ZZZ06076Z
BLUE SHIELD ID# - DME
CA
01
—
ZZZ06310Z
BLUE SHIELD ID#
CA
Enumeration date
10/25/2006
Last updated
07/26/2010
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