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PENINSULA PROSTHETICS INC. NPI 1043096811


NPI Information

NPI: 1043096811
Provider Name: PENINSULA PROSTHETICS, INC.
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
165 VALLEY DR
BRISBANE, CA
ZIP 94005
Phone: (916) 412-7813
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PENINSULA PROSTHETICS, INC. is a prosthetic orthotic supplier in Brisbane, CA. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. PENINSULA PROSTHETICS, INC. NPI is 1043096811. The provider is registered as an organization entity type.

The provider's business location address is:

165 VALLEY DR
BRISBANE, CA
ZIP 94005-340
Phone: (916) 412-7813
Fax: (866) 355-5906

The provider's authorized official is Jonathan Michael Smith .
The authorized official title is President and has the following contact phone number (916) 412-7813.

The enumeration date for this NPI number is 9/6/2023 and was last updated on 9/6/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic SupplierYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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