Provider Demographics
NPI:1881060499
Name:BAKERSFIELD SLEEP CENTER
Entity type:Organization
Organization Name:BAKERSFIELD SLEEP CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:SWOBODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-873-4911
Mailing Address - Street 1:5301 OFFICE PARK DR STE 305
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0653
Mailing Address - Country:US
Mailing Address - Phone:661-873-4911
Mailing Address - Fax:661-873-4912
Practice Address - Street 1:1141 PACIFIC ST STE F
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3307
Practice Address - Country:US
Practice Address - Phone:661-873-4911
Practice Address - Fax:661-873-4912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3485606207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty