Healthcare Provider Details

I. General information

NPI: 1518305317
Provider Name (Legal Business Name): SAN DIEGO SLEEP CENTER GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2013
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W PLAZA ST
SOLANA BEACH CA
92075-1123
US

IV. Provider business mailing address

125 W PLAZA ST
SOLANA BEACH CA
92075-1123
US

V. Phone/Fax

Practice location:
  • Phone: 858-350-9977
  • Fax: 858-350-9971
Mailing address:
  • Phone: 858-350-9977
  • Fax: 858-350-9971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DAVID F. URICH
Title or Position: CEO
Credential:
Phone: 858-350-9977