Healthcare Provider Details

I. General information

NPI: 1144348533
Provider Name (Legal Business Name): SLEEP DISORDERS ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 02/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7946 IVANHOE AVENUE SLEEP DISORDERS CENTER SUITE 209
LA JOLLA CA
92037
US

IV. Provider business mailing address

PO BOX 420187 SLEEP MEDICINE DEPARTMENT
SAN DIEGO CA
92142-0187
US

V. Phone/Fax

Practice location:
  • Phone: 858-598-4205
  • Fax:
Mailing address:
  • Phone: 858-598-4205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHERYL L SPINWEBER
Title or Position: DIRECTOR/SLEEP SPECIALIST
Credential:
Phone: 858-598-4205