Provider Demographics
NPI:1225257728
Name:JOAN OLOFF D P M INC
Entity Type:Organization
Organization Name:JOAN OLOFF D P M INC
Other - Org Name:LOS GATOS FOOT AND ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLOFF-SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:408-356-2774
Mailing Address - Street 1:15047 LOS GATOS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2054
Mailing Address - Country:US
Mailing Address - Phone:408-356-2774
Mailing Address - Fax:408-356-2140
Practice Address - Street 1:15047 LOS GATOS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2054
Practice Address - Country:US
Practice Address - Phone:408-356-2774
Practice Address - Fax:408-356-2140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE0358213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0658160002OtherDME PTAN
CA0658160002Medicare NSC