Provider Demographics
NPI:1467483487
Name:SLEEP DIAGNOSTIC SERVICES CORPORATION
Entity Type:Organization
Organization Name:SLEEP DIAGNOSTIC SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARO
Authorized Official - Suffix:
Authorized Official - Credentials:SECREATARY
Authorized Official - Phone:714-668-0629
Mailing Address - Street 1:2040 N TUSTIN AVE
Mailing Address - Street 2:SUITE #B
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7827
Mailing Address - Country:US
Mailing Address - Phone:714-668-0629
Mailing Address - Fax:714-668-0642
Practice Address - Street 1:2040 N TUSTIN AVE
Practice Address - Street 2:SUITE #B
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-7827
Practice Address - Country:US
Practice Address - Phone:714-668-0629
Practice Address - Fax:714-668-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic