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General NPI Number Information
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NPI Number | 1720782105
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Entity Type | Organization
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Legal Business Name | CARDIAC DIAGNOSTIC MONITORING SYSTEMS
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Dates
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Enumeration Date | 03/29/2023
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 3140 DE LA CRUZ BLVD 200
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City | SANTA CLARA
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State | CA
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Zip | 95054-2444
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Country | US
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Telephone | 801-427-1777
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Fax | 833-726-3279
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Provider Business Mailing Address
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Address Line | 881 W STATE RD # 140-101
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2131
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Country | US
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Telephone | 801-427-1777
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Fax | 833-726-3279
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | THOMAS FRY
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Credential |
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Telephone | 801-427-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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