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General NPI Number Information
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NPI Number | 1508956152
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Entity Type | Organization
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Legal Business Name | REM SLEEP LABS INCORPORATED
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 14642 NEWPORT AVE SUITE 260
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City | TUSTIN
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State | CA
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Zip | 92780-6057
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Country | US
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Telephone | 714-838-0052
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Fax | 714-838-0071
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Provider Business Mailing Address
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Address Line | 7 MUSICK
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City | IRVINE
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State | CA
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Zip | 92618-1638
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Country | US
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Telephone | 888-866-1211
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Fax | 888-866-1311
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FARSHAD FIROUZNAM
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Credential |
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Telephone | 888-866-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 99035247
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License Number State | CA
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