| Organization Name: | MONTEREY BAY SLEEP CENTER, LLC |
| NPI Number: | 1003290040 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN KOOSTRA (PARTNER) |
| Mailing Address: | 60 Garden Court Suite 250 Monterey |
| State: | CA US |
| Postal Code: | 93940 |
| Phone Number: | 8319201411 |
| Fax Number: | 8319201452 |
| NPI Enumeration Date: | 07/18/2015 |
| NPI Last Update Date: | 07/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1200X |
| License Number: | 261QS12000X |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Sleep Disorder Diagnostic |
| Taxonomy Definition: | |