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NPI Code Detail

MEDICARE: ADVANCED SLEEP MEDICINE SERVICES, INC.

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
1261QS1200XSleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number : 1194098384
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED SLEEP MEDICINE SERVICES, INC.
Provider Business Mailing Address
First Line : 17835 VENTURA BLVD
Second Line : SUITE 300
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 : 555 WASHINGTON ST
Second Line : SUITE 1037
City : SAN DIEGO
State : CA
Zip : 92103-2289
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 : 310-479-0500
Provider Enumeration Date : 02/17/2012
Last Update Date : 06/23/2017

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