Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A101435 | CA |
NPI | 1073669529 |
---|---|
Provider Name | Dr. Gregory Gerard Capra |
First Address | San Diego, CA 92134-5000 |
Second Address | San Diego, CA 92134-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 19/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD0000 | (02) | CA |