Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 20A9622 | CA |
NPI | 1184835860 |
---|---|
Provider Name | Nikolas George Capetanakis |
First Address | Encinitas, CA 92024-3742 |
Second Address | Encinitas, CA 92024-3742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 10/09/2013 |