Provider Demographics
NPI:1386861730
Name:ARIZONA MEDICAL SLEEP INSTITUTE, LLC
Entity Type:Organization
Organization Name:ARIZONA MEDICAL SLEEP INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKOOB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-933-0301
Mailing Address - Street 1:13634 N. 93RD AVE #100
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4915
Mailing Address - Country:US
Mailing Address - Phone:623-933-0301
Mailing Address - Fax:623-977-7257
Practice Address - Street 1:13203 N 103RD AVE
Practice Address - Street 2:SUITE I-1
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3028
Practice Address - Country:US
Practice Address - Phone:623-876-6997
Practice Address - Fax:623-876-6965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ118085Medicare PIN