Healthcare Provider Details

I. General information

NPI: 1881991669
Provider Name (Legal Business Name): ROY J CAPUTO MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 RIVERWALK PKWY STE 200
RIVERSIDE CA
92505-8510
US

IV. Provider business mailing address

PO BOX 1007
MURRIETA CA
92564-1007
US

V. Phone/Fax

Practice location:
  • Phone: 951-270-0882
  • Fax:
Mailing address:
  • Phone: 951-719-3330
  • Fax: 951-296-6741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberG57575
License Number StateCA

VIII. Authorized Official

Name: ROY J CAPUTO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 951-270-0882