Healthcare Provider Details

I. General information

NPI: 1205346723
Provider Name (Legal Business Name): GLIDIAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 SEQUOIA AVE
SOUTH SAN FRANCISCO CA
94080-1345
US

IV. Provider business mailing address

224 SEQUOIA AVE
SOUTH SAN FRANCISCO CA
94080-1345
US

V. Phone/Fax

Practice location:
  • Phone: 516-424-9515
  • Fax: 650-618-9859
Mailing address:
  • Phone: 516-424-9515
  • Fax: 650-618-9859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT ROMANO
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 952-215-6293