MEDICARE: DR. JOAN OLOFF D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	E3058	CA

General Provider Information

NPI Number	:	1780750711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAN OLOFF D.P.M.

Provider Business Mailing Address
First Line	:	15047 LOS GATOS BLVD
Second Line	:	SUITE 100
City	:	LOS GATOS
State	:	CA
Zip	:	95032-2054
Country	:	US
Telephone Number	:	408-356-2774
Fax Number	:	408-356-2140

Provider Business Practice Location Address
First Line	:	15047 LOS GATOS BLVD
Second Line	:	SUITE 100
City	:	LOS GATOS
State	:	CA
Zip	:	95032-2054
Country	:	US
Telephone Number	:	408-356-2774
Fax Number	:	408-356-2140

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	10/14/2011

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