Organization
CAPITOL UROLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE MYERS (PRACTICE MANAGER)
(916) 983-5557
Entity
Organization
Contact information
Practice address
1561 CREEKSIDE DR, SUITE 170, FOLSOM, CA 95630
(916) 983-5557
(916) 983-7878
Mailing address
1561 CREEKSIDE DR, SUITE 170, FOLSOM, CA 95630-3492
(916) 983-5557
(916) 983-7878
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
G59349
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0065840
—
CA
Enumeration date
07/23/2006
Last updated
11/25/2008
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