Organization
SLEEPMED OF CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL R IBERGER (EVP CFO)
(978) 536-7400
Entity
Organization
Contact information
Practice address
5400 BALBOA BLVD, SUITE 217, ENCINO, CA 91316-1502
(818) 817-9870
Mailing address
200 CORPORATE PL, STE 5B, PEABODY, MA 01960-3840
(978) 536-7400
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7618325
AETNA
CA
01
—
ZZZ59515Z
BLUE SHIELD CA
CA
Enumeration date
11/28/2006
Last updated
10/19/2009
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