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General NPI Number Information
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NPI Number | 1780736553
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Entity Type | Organization
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Legal Business Name | EDGARDO M CAPITULO MD INC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 1411 W SUNSET BLVD SUITE 203
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City | LOS ANGELES
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State | CA
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Zip | 90026-3431
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Country | US
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Telephone | 213-482-8313
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Fax | 213-481-7383
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Provider Business Mailing Address
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Address Line | 7657 WINNETKA AVE SUITE 267
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City | CANOGA PARK
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State | CA
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Zip | 91306-2677
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Country | US
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Telephone | 818-882-7656
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Fax | 818-773-9517
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDGARDO M CAPITULO
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Credential | MD
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Telephone | 818-882-7656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A43464
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License Number State | CA
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