Provider Demographics
NPI:1346423498
Name:COMPLETE SLEEP ANALYSIS LLC
Entity Type:Organization
Organization Name:COMPLETE SLEEP ANALYSIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-481-2577
Mailing Address - Street 1:10532 ACACIA ST
Mailing Address - Street 2:SUITE B-4
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5446
Mailing Address - Country:US
Mailing Address - Phone:909-481-2577
Mailing Address - Fax:949-863-0491
Practice Address - Street 1:4226 AVENIDA COCHISE
Practice Address - Street 2:SUITE 10
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-5818
Practice Address - Country:US
Practice Address - Phone:520-459-8618
Practice Address - Fax:520-458-2865
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AVASTRAUSA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-12
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies