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General NPI Number Information
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NPI Number | 1770012981
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Entity Type | Organization
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Legal Business Name | CARDIOGRAM, INC.
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 375 ALABAMA ST STE 350
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City | SAN FRANCISCO
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State | CA
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Zip | 94110
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Country | US
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Telephone | 425-293-3809
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Fax |
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Provider Business Mailing Address
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Address Line | 375 ALABAMA ST STE 400
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-1391
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Country | US
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Telephone | 425-293-3809
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRANDON MICHAEL BALLINGER
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Credential | BS
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Telephone | 425-293-3809
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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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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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