Provider Demographics
NPI:1972682631
Name:PACIFIC SLEEP MEDICINE A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:PACIFIC SLEEP MEDICINE A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:K
Authorized Official - Last Name:ERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-224-1855
Mailing Address - Street 1:6725 MESA RIDGE RD
Mailing Address - Street 2:SUITE 224
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2925
Mailing Address - Country:US
Mailing Address - Phone:858-224-1855
Mailing Address - Fax:858-224-1856
Practice Address - Street 1:2420 VISTA WAY
Practice Address - Street 2:SUITE 125
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6190
Practice Address - Country:US
Practice Address - Phone:858-224-1855
Practice Address - Fax:858-224-1856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA260037410OtherMEDICARE RAILROAD
CA260037410OtherMEDICARE RAILROAD