Provider Demographics
NPI:1184875684
Name:LOS ANGELES SLEEP DISORDERS GROUP
Entity type:Organization
Organization Name:LOS ANGELES SLEEP DISORDERS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRMIZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-556-0515
Mailing Address - Street 1:2796 SYCAMORE DR
Mailing Address - Street 2:#103
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1546
Mailing Address - Country:US
Mailing Address - Phone:805-582-0999
Mailing Address - Fax:
Practice Address - Street 1:3831 HUGHES AVE
Practice Address - Street 2:#510
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2751
Practice Address - Country:US
Practice Address - Phone:310-202-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADQ729AMedicare PIN