Provider Demographics
NPI:1841489499
Name:SLEEP DIAGNOSTIC SERVICES CORPORATION
Entity type:Organization
Organization Name:SLEEP DIAGNOSTIC SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-668-0629
Mailing Address - Street 1:6047 TAMPA AVE
Mailing Address - Street 2:SUITE #102
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-1158
Mailing Address - Country:US
Mailing Address - Phone:866-768-0629
Mailing Address - Fax:866-968-0642
Practice Address - Street 1:6047 TAMPA AVE
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:866-768-0629
Practice Address - Fax:866-968-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG590Medicare PIN