Provider Demographics
NPI:1215449806
Name:ELITE SLEEP INSTITUTE, LLC
Entity type:Organization
Organization Name:ELITE SLEEP INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DACQUISTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-844-2331
Mailing Address - Street 1:12264 EL CAMINO REAL STE 303
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3062
Mailing Address - Country:US
Mailing Address - Phone:760-844-2331
Mailing Address - Fax:
Practice Address - Street 1:12264 EL CAMINO REAL STE 303
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3062
Practice Address - Country:US
Practice Address - Phone:760-844-2331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty