Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | G75162 | CA |
N | 2084N0600X | Clinical Neurophysiologist | G75162 | CA |
NPI | 1508133828 |
---|---|
Provider Name | Dr. Nicholas Capozzoli |
First Address | Vacaville, CA 95696-2000 |
Second Address | Vacaville, CA 95696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2011 |
Last Update Date | 01/12/2011 |