Organization
PENINSULA PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN MICHAEL SMITH CPO (PRESIDENT)
(916) 412-7813
Entity
Organization
Contact information
Practice address
165 VALLEY DR, BRISBANE, CA 94005-1340
(916) 412-7813
(866) 355-5906
Mailing address
11 HAMILTON CT, PACIFICA, CA 94044-1543
(916) 412-7813
(866) 355-5906
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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