Provider Demographics
NPI:1306163506
Name:IMA SLEEP DISORDER CENTER COASTAL CAL, INC.
Entity type:Organization
Organization Name:IMA SLEEP DISORDER CENTER COASTAL CAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:NOORMAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-556-0335
Mailing Address - Street 1:2080 CENTURY PARK E
Mailing Address - Street 2:STE.608
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2001
Mailing Address - Country:US
Mailing Address - Phone:310-556-0335
Mailing Address - Fax:310-556-0330
Practice Address - Street 1:107 N HALL ST
Practice Address - Street 2:#B
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5850
Practice Address - Country:US
Practice Address - Phone:310-556-0335
Practice Address - Fax:310-556-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic