MEDICARE: MRS. MARINA NOEMI CAPELLA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A125409	CA

General Provider Information

NPI Number	:	1265711709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARINA NOEMI CAPELLA M.D.

Provider Business Mailing Address
First Line	:	3220 MISSION AVE
Second Line	:	UNIT 1
City	:	OCEANSIDE
State	:	CA
Zip	:	92058-1351
Country	:	US
Telephone Number	:	760-433-3155
Fax Number	:

Provider Business Practice Location Address
First Line	:	3220 MISSION AVE
Second Line	:	UNIT 1
City	:	OCEANSIDE
State	:	CA
Zip	:	92058-1351
Country	:	US
Telephone Number	:	760-433-3155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2011
Last Update Date	:	02/25/2015

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