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NPI Code Detail

MEDICARE: LEO J. CAPOBIANCO, D.O., LTD.

MEDICARE: LEO J. CAPOBIANCO, D.O., LTD.
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1891163770
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEO J. CAPOBIANCO, D.O., LTD.
Provider Business Mailing Address
First Line : 2801 N TENAYA WAY STE C
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-1400
Country : US
Telephone Number : 702-684-7800
Fax Number : 702-684-7878
Provider Business Practice Location Address
First Line : 6120 S FORT APACHE RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-6760
Country : US
Telephone Number : 702-602-5444
Fax Number : 702-602-5454
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. LEO CAPOBIANCO
Credential : D.O.
Telephone Number : 702-684-7800
Provider Enumeration Date : 09/09/2015
Last Update Date : 07/26/2023

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