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General NPI Number Information
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NPI Number | 1194778795
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Entity Type | Organization
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Legal Business Name | MIDWAY SLEEP LAB LLC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5901 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90036-4667
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Country | US
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Telephone | 323-933-0422
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Fax | 323-954-1822
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Provider Business Mailing Address
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Address Line | 9663 SANTA MONICA BLVD
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4303
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Country | US
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Telephone | 323-933-0422
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Fax | 323-954-1822
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Authorized Official
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Title or Position | PARTNER
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Name | ABRAHAM ISHAAYA
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Credential | MD
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Telephone | 323-293-6146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State | CA
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