MEDICARE: ADVANCED SLEEP MEDICINE SERVICES INC

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	291U00000X	Clinical Medical Laboratory		CA

General Provider Information

NPI Number	:	1134371289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED SLEEP MEDICINE SERVICES INC

Provider Business Mailing Address
First Line	:	17835 VENTURA BLVD SUITE 300
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316
Country	:	US
Telephone Number	:	877-775-3377
Fax Number	:	877-855-6227

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK E
Second Line	:	SUITE 1402
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2017
Country	:	US
Telephone Number	:	310-479-0500
Fax Number	:	310-402-2703

Authorized Official
Title or Position	:	CEO/ PRESIDENT
Name	:	KERMIT RAY NEWMAN
Credential	:
Telephone Number	:	877-775-3377

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	06/23/2017

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