Healthcare Provider Details
I. General information
NPI: 1184067647
Provider Name (Legal Business Name): THE GRADFORD GROUP (USA), INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/15/2013
Last Update Date: 04/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1250 CONNECTICUT AVE NW SUITE 200
WASHINGTON DC
20036-2603
US
IV. Provider business mailing address
1250 CONNECTICUT AVE NW SUITE 200
WASHINGTON DC
20036-2603
US
V. Phone/Fax
- Phone: 202-386-6789
- Fax: 202-240-5221
- Phone: 202-386-6789
- Fax: 202-240-5221
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
KAINGO
Title or Position: PRESIDENT & FOUNDER
Credential: M.D
Phone: 202-386-6789