Healthcare Provider Details

I. General information

NPI: 1689710063
Provider Name (Legal Business Name): JOSEPH THOMAS FERRANTE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 N MADISON AVE STE 512
PASADENA CA
91101-2035
US

IV. Provider business mailing address

65 N MADISON AVE STE 512
PASADENA CA
91101-2035
US

V. Phone/Fax

Practice location:
  • Phone: 626-577-0700
  • Fax: 626-796-3989
Mailing address:
  • Phone: 626-577-0700
  • Fax: 626-796-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4035
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberE4035
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4035
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: