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General NPI Number Information
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NPI Number | 1972918480
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Entity Type | Organization
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Legal Business Name | PERFORMANCE SLEEP LABS
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 1349 CAMINO DEL MAR STE F
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City | DEL MAR
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State | CA
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Zip | 92014-2553
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Country | US
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Telephone | 858-353-5455
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Fax |
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Provider Business Mailing Address
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Address Line | 1349 CAMINO DEL MAR SUITE F
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City | DEL MAR
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State | CA
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Zip | 92014-2553
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Country | US
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Telephone | 858-755-1166
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Fax | 888-399-9098
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | CAMERON ABBASOV
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Credential |
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Telephone | 858-353-5455
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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 | 3633810
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License Number State | CA
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