Provider Demographics
NPI:1104988823
Name:PINEDA, JOSEPH (DPM)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:PINEDA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 COAST VILLAGE CIR
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2710
Mailing Address - Country:US
Mailing Address - Phone:805-969-4305
Mailing Address - Fax:805-969-9979
Practice Address - Street 1:1206 COAST VILLAGE CIR
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-2710
Practice Address - Country:US
Practice Address - Phone:805-969-4305
Practice Address - Fax:805-969-9979
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3321174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE3321Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CAT11633Medicare UPIN