Healthcare Provider Details

I. General information

NPI: 1770012981
Provider Name (Legal Business Name): CARDIOGRAM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 ALABAMA ST STE 350
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

375 ALABAMA ST STE 400
SAN FRANCISCO CA
94110-1391
US

V. Phone/Fax

Practice location:
  • Phone: 425-293-3809
  • Fax:
Mailing address:
  • Phone: 425-293-3809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: BRANDON MICHAEL BALLINGER
Title or Position: CEO
Credential: BS
Phone: 425-293-3809