Provider Demographics
NPI:1588770580
Name:CAPOBIANCO, FRANCIS JOSEPH JR (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:JOSEPH
Last Name:CAPOBIANCO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:CAPOBIANCO
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2412 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7773
Mailing Address - Country:US
Mailing Address - Phone:916-774-7033
Mailing Address - Fax:916-774-7034
Practice Address - Street 1:2412 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-7788
Practice Address - Country:US
Practice Address - Phone:916-774-7033
Practice Address - Fax:916-774-7034
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG362192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00362190OtherPIN
CAEO245AOtherMEDICARE PTAN EO245A
CA00362190OtherPIN
CAB55437Medicare UPIN