MEDICARE: ABC SLEEP DISORDERS CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1023329455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC SLEEP DISORDERS CENTER

Provider Business Mailing Address
First Line	:	433 N 4TH ST STE 101B
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-4313
Country	:	US
Telephone Number	:	213-446-1819
Fax Number	:	818-450-0341

Provider Business Practice Location Address
First Line	:	433 N 4TH ST STE 101B
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-4313
Country	:	US
Telephone Number	:	213-446-1819
Fax Number	:	818-450-0341

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. MANUEL BESHLIKYAN
Credential	:	RPSGT
Telephone Number	:	213-446-1819

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	03/08/2021

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