1508956152 NPI number — REM SLEEP LABS INCORPORATED

Table of content: (NPI 1508956152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508956152 NPI number — REM SLEEP LABS INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REM SLEEP LABS INCORPORATED
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508956152
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 MUSICK
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92618-1638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-866-1211
Provider Business Mailing Address Fax Number:
888-866-1311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14642 NEWPORT AVE
Provider Second Line Business Practice Location Address:
SUITE 260
Provider Business Practice Location Address City Name:
TUSTIN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92780-6057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-838-0052
Provider Business Practice Location Address Fax Number:
714-838-0071
Provider Enumeration Date:
10/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FIROUZNAM
Authorized Official First Name:
FARSHAD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
888-866-1211

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  99035247 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2156248 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: P00320716 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 7825276 . This is a "AETNA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 157182589 . This is a "ABPA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZZ04605Z . This is a "BLUE SHIELD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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