Provider Demographics
NPI:1508956152
Name:REM SLEEP LABS INCORPORATED
Entity Type:Organization
Organization Name:REM SLEEP LABS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FIROUZNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-866-1211
Mailing Address - Street 1:7 MUSICK
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1638
Mailing Address - Country:US
Mailing Address - Phone:888-866-1211
Mailing Address - Fax:888-866-1311
Practice Address - Street 1:14642 NEWPORT AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6057
Practice Address - Country:US
Practice Address - Phone:714-838-0052
Practice Address - Fax:714-838-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99035247291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2156248OtherUNITED HEALTHCARE
CAP00320716OtherRAILROAD MEDICARE
CA7825276OtherAETNA
CA157182589OtherABPA
CAZZZ04605ZOtherBLUE SHIELD
CA7825276OtherAETNA