Provider Demographics
NPI:1427363258
Name:PACIFIC SLEEP MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:PACIFIC SLEEP MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIM
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-995-5400
Mailing Address - Street 1:PO BOX 6567
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90622-6567
Mailing Address - Country:US
Mailing Address - Phone:714-995-5400
Mailing Address - Fax:714-995-5254
Practice Address - Street 1:6800 LINCOLN AVE.
Practice Address - Street 2:205
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4164
Practice Address - Country:US
Practice Address - Phone:888-345-9858
Practice Address - Fax:714-827-2874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic