Provider Demographics
NPI:1114140191
Name:JOSEPH GIACOPELLI
Entity Type:Organization
Organization Name:JOSEPH GIACOPELLI
Other - Org Name:DANA POINT PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:GIACOPELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:949-248-4822
Mailing Address - Street 1:24865 DEL PRADO
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2853
Mailing Address - Country:US
Mailing Address - Phone:949-248-4822
Mailing Address - Fax:714-841-9595
Practice Address - Street 1:24865 DEL PRADO
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2853
Practice Address - Country:US
Practice Address - Phone:949-248-4822
Practice Address - Fax:714-841-9595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2231213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty