Provider Demographics
NPI:1326143843
Name:DIGICARDIO, INC.
Entity Type:Organization
Organization Name:DIGICARDIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-888-6882
Mailing Address - Street 1:28562 OSO PKWY
Mailing Address - Street 2:SUITE 340
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-5595
Mailing Address - Country:US
Mailing Address - Phone:949-888-6882
Mailing Address - Fax:949-888-6899
Practice Address - Street 1:18 PORTMARNOCH CT
Practice Address - Street 2:
Practice Address - City:COTO DE CAZA
Practice Address - State:CA
Practice Address - Zip Code:92679-5106
Practice Address - Country:US
Practice Address - Phone:949-888-6882
Practice Address - Fax:949-888-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACCI/ 0000022350246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG189Medicare ID - Type UnspecifiedIDTF