Provider Demographics
NPI:1922386432
Name:LONG BEACH SLEEP INSTITUTE
Entity Type:Organization
Organization Name:LONG BEACH SLEEP INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-497-7378
Mailing Address - Street 1:250 N WESTLAKE BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3700
Mailing Address - Country:US
Mailing Address - Phone:805-497-7378
Mailing Address - Fax:805-497-3776
Practice Address - Street 1:4300 LONG BEACH BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2011
Practice Address - Country:US
Practice Address - Phone:805-497-7378
Practice Address - Fax:562-490-8624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic