Basic Information
| Provider Information | |||||||||
| NPI: | 1386861730 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARIZONA MEDICAL SLEEP INSTITUTE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13634 N. 93RD AVE #100 | ||||||||
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| City: | PEORIA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853814915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239330301 | ||||||||
| FaxNumber: | 6239777257 | ||||||||
| Practice Location | |||||||||
| Address1: | 13203 N 103RD AVE | ||||||||
| Address2: | SUITE I-1 | ||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853513028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6238766997 | ||||||||
| FaxNumber: | 6238766965 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2007 | ||||||||
| LastUpdateDate: | 11/25/2019 | ||||||||
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| AuthorizedOfficialLastName: | YAKOOB | ||||||||
| AuthorizedOfficialFirstName: | SHAHID | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6239330301 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QS1200X | AZ | Y | Ambulatory Health Care Facilities | Clinic/Center | Sleep Disorder Diagnostic |
No ID Information.