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NPI 1720747074

NPI 1720747074 : SLEEPMAX : MALIBU, CA

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General NPI Number Information
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    NPI Number           |    1720747074
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    Entity Type          |    Organization 
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    Legal Business Name  |    SLEEPMAX 
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Dates
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    Enumeration Date     |    12/14/2021
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    Last Update Date     |    12/14/2021
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Provider Practice Location Address
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    Address Line         |    24955 PACIFIC COAST HWY STE C100 
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    City                 |    MALIBU
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    State                |    CA
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    Zip                  |    90265-4749
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    Country              |    US
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    Telephone            |    310-456-5700
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    Fax                  |    310-456-1475
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Provider Business Mailing Address
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    Address Line         |    24955 PACIFIC COAST HWY STE C100 
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    City                 |    MALIBU
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    State                |    CA
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    Zip                  |    90265-4749
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    Country              |    US
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    Telephone            |    310-456-5700
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    Fax                  |    310-456-1475
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ROBERT  PERKINS 
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    Credential           |    DDS
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    Telephone            |    310-456-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    332BC3200X
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    Taxonomy Name        |    Customized Equipment (DME)
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    License Number       |    
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    License Number State |    
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