Provider Demographics
NPI:1598000358
Name:DIAGNOSTIC SLEEP CENTER OF CALIFORNIA
Entity type:Organization
Organization Name:DIAGNOSTIC SLEEP CENTER OF CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:JAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-844-6036
Mailing Address - Street 1:2851 W 120TH ST
Mailing Address - Street 2:SUITE E1801
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-3395
Mailing Address - Country:US
Mailing Address - Phone:310-844-6036
Mailing Address - Fax:310-848-1315
Practice Address - Street 1:2851 W 120TH ST
Practice Address - Street 2:SUITE E1801
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-3395
Practice Address - Country:US
Practice Address - Phone:310-844-6036
Practice Address - Fax:310-848-1315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory