Provider Demographics
NPI:1972918480
Name:PERFORMANCE SLEEP LABS
Entity type:Organization
Organization Name:PERFORMANCE SLEEP LABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBASOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-353-5455
Mailing Address - Street 1:1349 CAMINO DEL MAR
Mailing Address - Street 2:SUITE F
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2553
Mailing Address - Country:US
Mailing Address - Phone:858-755-1166
Mailing Address - Fax:888-399-9098
Practice Address - Street 1:1349 CAMINO DEL MAR STE F
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2553
Practice Address - Country:US
Practice Address - Phone:858-353-5455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3633810261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic