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General NPI Number Information
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NPI Number | 1952634123
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Entity Type | Organization
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Legal Business Name | PHOENIX SLEEP DISORDER CENTER INC.
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Dates
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Enumeration Date | 09/04/2009
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 8618 N 35TH AVE ST 1
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City | PHOENIX
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State | AZ
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Zip | 85051-3800
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Country | US
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Telephone | 602-374-3677
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Fax |
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Provider Business Mailing Address
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Address Line | 8618 N 35TH AVE ST 1
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City | PHOENIX
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State | AZ
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Zip | 85051-3800
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Country | US
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Telephone | 602-374-3677
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Fax | 602-374-5634
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZEPUR DILANCHYAN
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Credential |
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Telephone | 602-374-3677
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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 | OTC4825
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License Number State | AZ
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