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General NPI Number Information
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NPI Number | 1942357579
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Entity Type | Organization
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Legal Business Name | GOOD NIGHT SLEEP CLINIC, INC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 12555 GARDEN GROVE BLVD SUITE 307
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1902
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Country | US
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Telephone | 714-537-2300
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Fax | 714-537-4300
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Provider Business Mailing Address
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Address Line | 12555 GARDEN GROVE BLVD SUITE 307
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1902
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Country | US
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Telephone | 714-537-2300
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Fax | 714-537-4300
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES J KIM
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Credential | M.D.
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Telephone | 714-537-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | A49011
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License Number State | CA
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