Healthcare Provider Details
I. General information
NPI: 1679515290
Provider Name (Legal Business Name): ROCHELLE CAPLAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10833 LE CONTE AVE 12-441 MDCC
LOS ANGELES CA
90095-3075
US
IV. Provider business mailing address
10833 LE CONTE AVE 12-441 MDCC
LOS ANGELES CA
90095-3075
US
V. Phone/Fax
- Phone: 310-206-3952
- Fax: 310-206-0209
- Phone: 310-206-3952
- Fax: 310-206-0209
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | A42989 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: