MEDICARE: LISA CAPALDINI MD

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	207R00000X	Internal Medicine Physician	G54552	CA

General Provider Information

NPI Number	:	1841249240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA CAPALDINI MD

Provider Business Mailing Address
First Line	:	21663 BRIAN LN STE C
Second Line	:
City	:	SONORA
State	:	CA
Zip	:	95370-9065
Country	:	US
Telephone Number	:	209-586-1400
Fax Number	:	800-898-0558

Provider Business Practice Location Address
First Line	:	45 CASTRO ST
Second Line	:	STE 227
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94114-1033
Country	:	US
Telephone Number	:	415-861-3366
Fax Number	:	415-861-3189

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	04/27/2022

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