Basic Information
| Provider Information | |||||||||
| NPI: | 1417317801 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOMNIUM CARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23052 ALICIA PKWY # 619 | ||||||||
| Address2: | |||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926921643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148565472 | ||||||||
| FaxNumber: | 7148089393 | ||||||||
| Practice Location | |||||||||
| Address1: | 23052 ALICIA PKWY # 619 | ||||||||
| Address2: | |||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926921643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148565472 | ||||||||
| FaxNumber: | 7148089393 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/29/2016 | ||||||||
| LastUpdateDate: | 05/02/2016 | ||||||||
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| AuthorizedOfficialLastName: | GONZALEZ | ||||||||
| AuthorizedOfficialFirstName: | ROSEANN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7148565472 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QS1200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Sleep Disorder Diagnostic |
No ID Information.