Healthcare Provider Details

I. General information

NPI: 1356263784
Provider Name (Legal Business Name): ANUMANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S NORFOLK ST STE 350
SAN MATEO CA
94403-1164
US

IV. Provider business mailing address

1 MAIN ST STE 400
CAMBRIDGE MA
02142-1531
US

V. Phone/Fax

Practice location:
  • Phone: 844-268-6262
  • Fax:
Mailing address:
  • Phone: 844-268-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. SIMEON KEDIKOGLOU
Title or Position: PRESIDENT & CHIEF OPERATING OFFICER
Credential: MD
Phone: 844-268-6262