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Individual

DR. CARMEN C CAPODANNO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1360 W 6TH ST, STE 270, SAN PEDRO, CA 90732-3539
(310) 831-1272
(310) 831-1273
Mailing address
1360 W 6TH ST, STE 270, SAN PEDRO, CA 90732-3539
(310) 831-1272
(310) 831-1273

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
636220
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G362200
CA
Enumeration date
06/08/2005
Last updated
07/08/2007
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