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General NPI Number Information
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NPI Number | 1922309129
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Entity Type | Organization
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Legal Business Name | NICHOLAS JOHN CAPOS JR MD INC.
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 1044 LIVE OAK BLVD
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City | YUBA CITY
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State | CA
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Zip | 95991-3415
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Country | US
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Telephone | 530-673-6140
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Fax | 530-673-3144
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Provider Business Mailing Address
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Address Line | 1044 LIVE OAK BLVD
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City | YUBA CITY
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State | CA
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Zip | 95991-3415
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Country | US
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Telephone | 530-673-6140
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Fax | 530-673-3144
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Authorized Official
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Title or Position | CARDIOLOGIST/DOCTOR
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Name | DR. NICHOLAS JOHN CAPOS JR.
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Credential | M.D.,
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Telephone | 530-673-6140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 00G414570
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License Number State | CA
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