Healthcare Provider Details

I. General information

NPI: 1164820650
Provider Name (Legal Business Name): DIAGNOSTIC RESPIRATORY EVALUATIONS APNEA MONITORING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2014
Last Update Date: 12/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 H ST SUITE 5000
CHULA VISTA CA
91910-5555
US

IV. Provider business mailing address

333 H ST SUITE 5000
CHULA VISTA CA
91910-5555
US

V. Phone/Fax

Practice location:
  • Phone: 619-274-3578
  • Fax: 619-550-3626
Mailing address:
  • Phone: 619-274-3578
  • Fax: 619-550-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number27927
License Number StateCA

VIII. Authorized Official

Name: MR. CHRISTOPHER ANDREW PARKER
Title or Position: REGISTERED RESPIRATORY THERAPIST
Credential: CRT, RRT
Phone: 619-274-3578