Provider Demographics
NPI:1720548936
Name:GARIBALDI, MATTHEW GUY (MS, CPO)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:GUY
Last Name:GARIBALDI
Suffix:
Gender:M
Credentials:MS, CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1500 OWENS ST STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2338
Mailing Address - Country:US
Mailing Address - Phone:415-476-1788
Mailing Address - Fax:415-476-7003
Practice Address - Street 1:1500 OWENS ST STE 115
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2338
Practice Address - Country:US
Practice Address - Phone:415-476-1788
Practice Address - Fax:415-476-7003
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1973OtherAMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS, INC.