Healthcare Provider Details

I. General information

NPI: 1750713343
Provider Name (Legal Business Name): PCH SLEEP DISORDER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 08/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 E PACIFIC COAST HWY SUITE B
LONG BEACH CA
90804
US

IV. Provider business mailing address

2990 E PACIFIC COAST HWY SUITE B
LONG BEACH CA
90804
US

V. Phone/Fax

Practice location:
  • Phone: 562-343-7182
  • Fax:
Mailing address:
  • Phone: 562-343-7182
  • Fax:

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: LISA HOANG
Title or Position: MANAGER
Credential:
Phone: 562-343-7182