MEDICARE: MR. FRANK J CAPATCH LCSW

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	1041C0700X	Clinical Social Worker	3265	HI

General Provider Information

NPI Number	:	1285765420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANK J CAPATCH LCSW

Provider Business Mailing Address
First Line	:	PO BOX 1341
Second Line	:	14-803 SEAVIEW RD
City	:	PAHOA
State	:	HI
Zip	:	96778-1341
Country	:	US
Telephone Number	:	808-965-5349
Fax Number	:	808-965-5036

Provider Business Practice Location Address
First Line	:	14-803 SEAVIEW RD
Second Line	:	NANAWALE ESTATES
City	:	PAHOA
State	:	HI
Zip	:	96778-1341
Country	:	US
Telephone Number	:	808-965-5349
Fax Number	:	808-965-5036

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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