Individual
CHARLOTTE CAPULONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
130 WEST ROUTE 66, STE 326, GLENDORA, CA 91740-6252
(626) 963-8588
(626) 963-8578
Mailing address
PO BOX 457, SAN DIMAS, CA 91773-0457
(909) 971-9334
(909) 971-9654
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP23824
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP23824
STATE LICENSE
CA
Enumeration date
01/31/2014
Last updated
01/31/2014
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