Provider Demographics
NPI:1295126274
Name:RESTORE MEDICAL INC
Entity type:Organization
Organization Name:RESTORE MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DUNPHY
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:530-605-4292
Mailing Address - Street 1:2075 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3716
Mailing Address - Country:US
Mailing Address - Phone:925-930-7801
Mailing Address - Fax:925-930-9739
Practice Address - Street 1:2075 N BROADWAY
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3716
Practice Address - Country:US
Practice Address - Phone:925-930-7801
Practice Address - Fax:925-930-9739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier