Healthcare Provider Details

I. General information

NPI: 1306915749
Provider Name (Legal Business Name): SAN FRANCISCO PROSTHETIC ORTHOTIC SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 10/14/2020
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 DIVISADERO ST
SAN FRANCISCO CA
94117-2209
US

IV. Provider business mailing address

330 DIVISADERO ST
SAN FRANCISCO CA
94117-2209
US

V. Phone/Fax

Practice location:
  • Phone: 415-861-4146
  • Fax: 415-861-0653
Mailing address:
  • Phone: 415-861-4146
  • Fax: 415-861-0653

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: MS. EMILY B LUND
Title or Position: PRESIDENT
Credential:
Phone: 415-861-4146