MEDICARE: LAUREL SLEEP 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	:	1285209890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAUREL SLEEP CENTER

Provider Business Mailing Address
First Line	:	6260 LAUREL CANYON BLVD STE 301
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3243
Country	:	US
Telephone Number	:	818-824-3529
Fax Number	:	818-824-3530

Provider Business Practice Location Address
First Line	:	6260 LAUREL CANYON BLVD STE 301
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3243
Country	:	US
Telephone Number	:	818-824-3529
Fax Number	:	818-824-3530

Authorized Official
Title or Position	:	CEO
Name	:	LIANNA ITCHMELIAN
Credential	:
Telephone Number	:	818-824-1031

Provider Enumeration Date	:	05/25/2021
Last Update Date	:	05/25/2021

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Directions to “LAUREL SLEEP CENTER ” Practice Location

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