Healthcare Provider Details

I. General information

NPI: 1104985357
Provider Name (Legal Business Name): SUNSET SLEEP LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2796 SYCAMORE DR SUITE103
SIMI VALLEY CA
93065-1546
US

IV. Provider business mailing address

2796 SYCAMORE DR SUITE103
SIMI VALLEY CA
93065-1546
US

V. Phone/Fax

Practice location:
  • Phone: 805-582-0999
  • Fax: 805-582-0919
Mailing address:
  • Phone: 805-582-0999
  • Fax: 805-582-0919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. BRUCE L EDWARDS
Title or Position: PRESIDENT
Credential:
Phone: 805-582-0999