Provider Demographics
NPI:1932659547
Name:ADVANCED SLEEP MEDICINE SERVICES, INC.
Entity Type:Organization
Organization Name:ADVANCED SLEEP MEDICINE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KERMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-775-3377
Mailing Address - Street 1:17835 VENTURA BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3634
Mailing Address - Country:US
Mailing Address - Phone:877-775-3377
Mailing Address - Fax:
Practice Address - Street 1:5400 BALBOA BLVD
Practice Address - Street 2:STE 126
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1502
Practice Address - Country:US
Practice Address - Phone:877-775-3377
Practice Address - Fax:877-855-6227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic