Lucid Sleep Inc.

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

License

2558471 Issued in CA

Legal business name

LUCID SLEEP INC.

Practice address

17497 Main St
Hesperia, CA 92345-6268

Phone

(877) 995-8243

Fax

(877) 995-8253

NPI assigned

Aug 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mikael Enevoldsen, RPSGT

Title

Ceo

Phone

(877) 995-8243

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629185343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 MONROVIA AVE STE C6",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926274418",
            "telephone_number": "877-995-8243",
            "fax_number": "877-995-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17497 MAIN ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923456268",
            "telephone_number": "877-995-8243",
            "fax_number": "877-995-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCID SLEEP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENEVOLDSEN",
        "authorized_official_first_name": "MIKAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-995-8243",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPSGT"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "CA",
            "license": "2558471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sleep Disorder Diagnostic Clinic/Center in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Sleep Disorder Diagnostic Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.