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General NPI Number Information
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NPI Number | 1699918805
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Entity Type | Organization
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Legal Business Name | SLEEP MED OF L.A., INC.
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 369 S DOHENY DR # 159
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3577
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Country | US
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Telephone | 310-925-1145
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Fax |
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Provider Business Mailing Address
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Address Line | 369 S DOHENY DR # 159
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3577
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Country | US
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Telephone | 310-925-1145
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SASAN NICKBAKHT
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Credential |
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Telephone | 310-925-1145
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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 | B8121131
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License Number State | CA
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