Healthcare Provider Details

I. General information

NPI: 1275204976
Provider Name (Legal Business Name): THE BREATHE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10921 WILSHIRE BLVD STE 912
LOS ANGELES CA
90024-3906
US

IV. Provider business mailing address

10921 WILSHIRE BLVD STE 912
LOS ANGELES CA
90024-3906
US

V. Phone/Fax

Practice location:
  • Phone: 310-579-9710
  • Fax:
Mailing address:
  • Phone: 310-579-9710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LEYLI NOROUZ
Title or Position: MANAGING DIRECTOR AND CO-FOUNDER
Credential:
Phone: 310-579-9710