Healthcare Provider Details

I. General information

NPI: 1427001353
Provider Name (Legal Business Name): SLEEP CENTER OF SO ORANGE CTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9663 SANTA MONICA BLVD
BEVERLY HILLS CA
90210-4303
US

IV. Provider business mailing address

27882 FORBES RD
LAGUNA NIGUEL CA
92677-1219
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-6600
  • Fax: 949-364-7065
Mailing address:
  • Phone: 949-364-6600
  • Fax: 949-364-7065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM ISHAAYA
Title or Position: PARTNER
Credential: MD
Phone: 949-364-6600