MEDICARE: PACIFIC SLEEP MEDICINE A MEDICAL CORPORATION

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	260037410	OTHER	CA	MEDICARE RAILROAD

General Provider Information

NPI Number	:	1972682631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC SLEEP MEDICINE A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	6725 MESA RIDGE RD
Second Line	:	SUITE 224
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-2925
Country	:	US
Telephone Number	:	858-224-1855
Fax Number	:	858-224-1856

Provider Business Practice Location Address
First Line	:	2420 VISTA WAY
Second Line	:	SUITE 125
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6190
Country	:	US
Telephone Number	:	858-224-1855
Fax Number	:	858-224-1856

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MILTON K ERMAN
Credential	:	M.D.
Telephone Number	:	858-224-1855

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	04/13/2012

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