Organization
LAURENCE OF OAKLAND
Active
Other names
Laurence Orthopedic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT A JENSEN CPO (PRESIDENT)
(510) 658-2062
Entity
Organization
Contact information
Practice address
2190 MERIDIAN PARK BLVD STE E, CONCORD, CA 94520-5715
(925) 827-2062
(925) 827-2503
Mailing address
6001 TELEGRAPH AVE, OAKLAND, CA 94609-1310
(510) 658-2062
(510) 652-7779
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GFC000120
—
CA
Enumeration date
01/14/2008
Last updated
02/13/2008
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