Healthcare Provider Details

I. General information

NPI: 1154573616
Provider Name (Legal Business Name): ADVANCED SLEEP MEDICINE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23961 CALLE DE LA MAGDALENA SUITE 519
LAGUNA HILLS CA
92653-7622
US

IV. Provider business mailing address

17835 VENTURA BLVD STE 300
ENCINO CA
91316-3677
US

V. Phone/Fax

Practice location:
  • Phone: 877-775-3377
  • Fax: 877-855-6227
Mailing address:
  • Phone: 877-775-3377
  • Fax: 877-855-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KERMIT RAY NEWMAN
Title or Position: CEO/ PRESIDENT
Credential:
Phone: 877-775-3377