Provider Demographics
NPI:1750476651
Name:GAROFALO, JOSEPH T (DPM)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T
Last Name:GAROFALO
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 1:122 S PATTERSON AVE
Mailing Address - Street 2:101
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2055
Mailing Address - Country:US
Mailing Address - Phone:805-964-3541
Mailing Address - Fax:805-964-6461
Practice Address - Street 1:122 S PATTERSON AVE
Practice Address - Street 2:101
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2055
Practice Address - Country:US
Practice Address - Phone:805-964-3541
Practice Address - Fax:805-964-6461
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1384213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10927Medicare UPIN
CA5129090001Medicare NSC