Healthcare Provider Details

I. General information

NPI: 1053349761
Provider Name (Legal Business Name): DR FRANK J GAROFALO DPM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N PACIFIC AVE STE 104
GLENDALE CA
91202-4313
US

IV. Provider business mailing address

1101 N PACIFIC AVE STE 104
GLENDALE CA
91202-4313
US

V. Phone/Fax

Practice location:
  • Phone: 818-552-5000
  • Fax: 818-552-2959
Mailing address:
  • Phone: 818-552-5000
  • Fax: 818-552-2959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE1174
License Number StateCA

VIII. Authorized Official

Name: DR. FRANK J GAROFALO
Title or Position: PRESIDENT
Credential: DPM
Phone: 818-552-5000