Provider Demographics
NPI:1912243700
Name:ALIGN CLINIC LLC
Entity Type:Organization
Organization Name:ALIGN CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:650-888-5573
Mailing Address - Street 1:700 S CLAREMONT ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1452
Mailing Address - Country:US
Mailing Address - Phone:650-375-2231
Mailing Address - Fax:650-627-4632
Practice Address - Street 1:700 S CLAREMONT ST
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1452
Practice Address - Country:US
Practice Address - Phone:650-375-2231
Practice Address - Fax:650-627-4632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
Yes335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty