Provider Demographics
NPI:1427001353
Name:SLEEP CENTER OF SO ORANGE CTY
Entity Type:Organization
Organization Name:SLEEP CENTER OF SO ORANGE CTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ISHAAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-364-6600
Mailing Address - Street 1:27882 FORBES RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1219
Mailing Address - Country:US
Mailing Address - Phone:949-364-6600
Mailing Address - Fax:949-364-7065
Practice Address - Street 1:9663 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4303
Practice Address - Country:US
Practice Address - Phone:949-364-6600
Practice Address - Fax:949-364-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID