Provider Demographics
NPI:1164996658
Name:RESTORE MEDICAL INC
Entity Type:Organization
Organization Name:RESTORE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KATI
Authorized Official - Middle Name:
Authorized Official - Last Name:AUXIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-523-7670
Mailing Address - Street 1:7335 N 1ST ST STE 109
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2968
Mailing Address - Country:US
Mailing Address - Phone:559-439-6152
Mailing Address - Fax:559-439-6185
Practice Address - Street 1:7335 N 1ST ST STE 109
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2968
Practice Address - Country:US
Practice Address - Phone:559-439-6152
Practice Address - Fax:559-439-6185
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTORE MEDICAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-17
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier