Healthcare Provider Details

I. General information

NPI: 1295507416
Provider Name (Legal Business Name): MY SLEEP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 GEARY BLVD STE 214
SAN FRANCISCO CA
94118-3013
US

IV. Provider business mailing address

4444 GEARY BLVD STE 214
SAN FRANCISCO CA
94118-3013
US

V. Phone/Fax

Practice location:
  • Phone: 408-922-9036
  • Fax:
Mailing address:
  • Phone: 408-922-9036
  • Fax:

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 Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ROBERT JONATHAN GOMEZ
Title or Position: CEO
Credential:
Phone: 408-922-9036