Healthcare Provider Details

I. General information

NPI: 1003626797
Provider Name (Legal Business Name): SLEEP RESET MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 LONG BRIDGE ST APT 1609
SAN FRANCISCO CA
94158-2564
US

IV. Provider business mailing address

1 HAWTHORNE ST UNIT 2C
SAN FRANCISCO CA
94105-3976
US

V. Phone/Fax

Practice location:
  • Phone: 919-943-6011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SHIMIN OOI
Title or Position: OPERATIONS ADMINISTRATOR
Credential:
Phone: 862-235-4743