Healthcare Provider Details

I. General information

NPI: 1043639420
Provider Name (Legal Business Name): OPTIMAL SLEEP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N MARENGO AVE STE 110
PASADENA CA
91101-1563
US

IV. Provider business mailing address

215 N MARENGO AVE STE 110
PASADENA CA
91101-1563
US

V. Phone/Fax

Practice location:
  • Phone: 818-424-9006
  • Fax: 626-410-6686
Mailing address:
  • Phone: 626-600-5666
  • Fax: 626-410-6686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ARUSYAK KHACHATRYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-424-9006