# PRIME CARE SLEEP CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164857603
- **Authorized official:** SIAMAK HEYDARIAN M.D. (OWNER)
- **Authorized official phone:** (571) 408-4476

## Contact information

- **Practice address:** 2200 OPITZ BLVD, SUITE 340, WOODBRIDGE, VA 22191-3321
- **Practice address phone:** (571) 408-4476
- **Practice address fax:** (571) 408-4479
- **Mailing address:** 2200 OPITZ BLVD, SUITE 340, WOODBRIDGE, VA 22191-3321
- **Mailing address phone:** (571) 408-4476
- **Mailing address fax:** (571) 408-4479

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | 0101048248 | VA | Yes |

## Other

- **Enumeration date:** 09/03/2013
- **Last updated:** 09/03/2013