Provider Demographics
NPI:1265711709
Name:CAPELLA, MARINA NOEMI (MD)
Entity type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:NOEMI
Last Name:CAPELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 MISSION AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1351
Mailing Address - Country:US
Mailing Address - Phone:760-433-3155
Mailing Address - Fax:
Practice Address - Street 1:3220 MISSION AVE
Practice Address - Street 2:UNIT 1
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1351
Practice Address - Country:US
Practice Address - Phone:760-433-3155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125409208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics