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General NPI Number Information
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NPI Number | 1912243700
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Entity Type | Organization
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Legal Business Name | ALIGN CLINIC LLC
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Dates
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Enumeration Date | 12/24/2012
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Last Update Date | 11/24/2015
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Provider Practice Location Address
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Address Line | 700 S CLAREMONT ST SUITE 105
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City | SAN MATEO
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State | CA
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Zip | 94402-1452
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Country | US
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Telephone | 650-375-2231
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Fax | 650-627-4632
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Provider Business Mailing Address
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Address Line | 700 S CLAREMONT ST SUITE 105
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City | SAN MATEO
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State | CA
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Zip | 94402-1452
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Country | US
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Telephone | 650-375-2231
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Fax | 650-627-4632
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Authorized Official
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Title or Position | CEO
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Name | MR. GRANT IAN WOOD
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Credential | CPO
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Telephone | 650-888-5573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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