Healthcare Provider Details

I. General information

NPI: 1164568614
Provider Name (Legal Business Name): LEONARD CAPUTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 S MAIN ST
SALINAS CA
93901-2260
US

IV. Provider business mailing address

1212 S MAIN ST
SALINAS CA
93901-2260
US

V. Phone/Fax

Practice location:
  • Phone: 831-422-7777
  • Fax: 831-422-0136
Mailing address:
  • Phone: 831-422-7777
  • Fax: 831-422-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG78147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: