Provider Demographics
NPI:1922107739
Name:SOMNOMEDIX CORPORATION
Entity Type:Organization
Organization Name:SOMNOMEDIX CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:JANDEBEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-461-1444
Mailing Address - Street 1:5220 CLARK AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2618
Mailing Address - Country:US
Mailing Address - Phone:562-461-1444
Mailing Address - Fax:562-461-2929
Practice Address - Street 1:5220 CLARK AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2618
Practice Address - Country:US
Practice Address - Phone:562-461-1444
Practice Address - Fax:562-461-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
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
CATG191Medicare ID - Type Unspecified