MEDICARE: CARE DIALOGUE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1114712437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE DIALOGUE INC

Provider Business Mailing Address
First Line	:	1601 BAYSHORE HWY STE 250
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-1520
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 BAYSHORE HWY STE 250
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-1520
Country	:	US
Telephone Number	:	650-260-4118
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	VITALIY GOFMAN
Credential	:
Telephone Number	:	415-816-5837

Provider Enumeration Date	:	04/09/2025
Last Update Date	:	04/09/2025

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Directions to “CARE DIALOGUE INC ” Practice Location

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