MEDICARE: MR. CRAIG STEVEN GARFOLO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E3309	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629028923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CRAIG STEVEN GARFOLO DPM

Provider Business Mailing Address
First Line	:	PO BOX 77883
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95267-1183
Country	:	US
Telephone Number	:	209-473-1011
Fax Number	:	209-473-4317

Provider Business Practice Location Address
First Line	:	2800 N CALIFORNIA ST STE 11
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-3758
Country	:	US
Telephone Number	:	209-473-1011
Fax Number	:	209-473-4317

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	04/25/2024

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