Provider Demographics
NPI:1710296090
Name:CORONA SLEEP & WELLNESS, LLC
Entity Type:Organization
Organization Name:CORONA SLEEP & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/SALES
Authorized Official - Prefix:MISS
Authorized Official - First Name:BELAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-339-9553
Mailing Address - Street 1:2815 S. MAIN ST.
Mailing Address - Street 2:SUITE # 115
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2815 S. MAIN ST.
Practice Address - Street 2:SUITE # 115
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882
Practice Address - Country:US
Practice Address - Phone:310-339-9553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory