=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780173146
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAN FRANCISCO SLEEP APNEA CENTERS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2018
-----------------------------------------------------
Last Update Date | 05/01/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 350 PARNASSUS AVE STE 304B
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94117-3608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-761-1846
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 550 N BRAND BLVD STE 1500
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91203-1922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-553-4535
-----------------------------------------------------
Fax | 213-402-5670
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ARMEN MIRZAYAN
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 213-553-4535
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------