Provider Demographics
NPI:1235257841
Name:AMERICAN SLEEP MEDICINE & DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:AMERICAN SLEEP MEDICINE & DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MO
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMJID
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:951-461-3030
Mailing Address - Street 1:23865 MATADOR WAY
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4696
Mailing Address - Country:US
Mailing Address - Phone:951-461-3030
Mailing Address - Fax:951-461-3350
Practice Address - Street 1:25470 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 104
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-461-3030
Practice Address - Fax:951-461-3350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA06146291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory