MEDICARE: SAN DIEGO SLEEP CENTER GROUP, 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	332BC3200X	Customized Equipment (DME)
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1518305317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN DIEGO SLEEP CENTER GROUP, INC.

Provider Business Mailing Address
First Line	:	125 W PLAZA ST
Second Line	:
City	:	SOLANA BEACH
State	:	CA
Zip	:	92075-1123
Country	:	US
Telephone Number	:	858-350-9977
Fax Number	:	858-350-9971

Provider Business Practice Location Address
First Line	:	125 W PLAZA ST
Second Line	:
City	:	SOLANA BEACH
State	:	CA
Zip	:	92075-1123
Country	:	US
Telephone Number	:	858-350-9977
Fax Number	:	858-350-9971

Authorized Official
Title or Position	:	CEO
Name	:	DAVID F. URICH
Credential	:
Telephone Number	:	858-350-9977

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	02/16/2026

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