Provider Demographics
NPI:1780750711
Name:OLOFF, JOAN (DPM)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:OLOFF
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15047 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
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3058213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11561Medicare UPIN
CA000E30580Medicare ID - Type Unspecified