Provider Demographics
NPI:1689710063
Name:FERRANTE, JOSEPH THOMAS (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:FERRANTE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 N MADISON AVE
Mailing Address - Street 2:STE 512
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2035
Mailing Address - Country:US
Mailing Address - Phone:626-577-0700
Mailing Address - Fax:626-796-3989
Practice Address - Street 1:65 N MADISON AVE
Practice Address - Street 2:STE 512
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2035
Practice Address - Country:US
Practice Address - Phone:626-577-0700
Practice Address - Fax:626-796-3989
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4035213E00000X, 213ES0000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0004468873OtherAETNA
CAZZZ070012OtherBLUE CROSS
CA000E40351Medicaid
CAZZZ070012OtherBLUE SHIELD
CAPR53338680002OtherCIGNA
CAWE4035AMedicare ID - Type Unspecified
CAZZZ070012OtherBLUE CROSS