Healthcare Provider Details

I. General information

NPI: 1316883523
Provider Name (Legal Business Name): APPLIED ORTHOTICS AND PROSTHETICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 MARCO POLO WAY STE 10
BURLINGAME CA
94010-4500
US

IV. Provider business mailing address

455 OCONNOR DR STE 360
SAN JOSE CA
95128-1646
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-9741
  • Fax: 408-358-1281
Mailing address:
  • Phone: 408-358-9741
  • Fax: 408-358-1281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN SMITH
Title or Position: PRESIDENT
Credential: CPO
Phone: 916-412-7813