Organization
ADVANCED SLEEP DISORDER CENTER, INC.
Active
Organization
ADVANCED SLEEP DISORDER CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN SAM DAVIDSON M.D. (OWNER)
(209) 751-7165
Entity
Organization
Contact information
Practice address
4206 TECHNOLOGY DR STE 2, MODESTO, CA 95356-9484
(209) 751-7165
Mailing address
4206 TECHNOLOGY DR STE 2, MODESTO, CA 95356-9484
(209) 751-7165
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
G66389
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
G66389
CA
261Q00000X
Clinic/Center
Primary
G66389
CA
Other
Enumeration date
12/21/2007
Last updated
08/16/2013
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