MEDICARE: REM DIAGNOSTICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1497730394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REM DIAGNOSTICS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1708
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93406-1708
Country	:	US
Telephone Number	:	805-785-0126
Fax Number	:	805-784-0127

Provider Business Practice Location Address
First Line	:	1329 BROAD ST STE C
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-1928
Country	:	US
Telephone Number	:	805-785-0126
Fax Number	:	805-785-0127

Authorized Official
Title or Position	:	OWNER
Name	:	GREGG SWOBODA
Credential	:
Telephone Number	:	805-785-0126

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	01/09/2023

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