Organization
LEAHY PROSTHETICS & ORTHOTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN M LEAHY CP (CEO)
(831) 425-5900
Entity
Organization
Contact information
Practice address
630 FREDERICK ST, SANTA CRUZ, CA 95062-2203
(831) 425-5900
(831) 425-0488
Mailing address
630 FREDERICK ST, SANTA CRUZ, CA 95062
(831) 425-5900
(831) 425-0488
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CP2178
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XB0021780
CENTRAL COAST ALLIANCE FO
—
Enumeration date
07/08/2006
Last updated
08/22/2020
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