Provider Demographics
NPI:1114248143
Name:BRAND DIAGNOSTIC & SLEEP CENTER INC.
Entity Type:Organization
Organization Name:BRAND DIAGNOSTIC & SLEEP CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-255-3355
Mailing Address - Street 1:1141 N. BRAND BLVD.
Mailing Address - Street 2:SUITE. 304
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202
Mailing Address - Country:US
Mailing Address - Phone:323-255-3355
Mailing Address - Fax:323-255-3255
Practice Address - Street 1:1141 N BRAND BLVD STE 304
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2579
Practice Address - Country:US
Practice Address - Phone:323-255-3355
Practice Address - Fax:323-255-3255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic