Provider Demographics
NPI:1861963365
Name:CAPITOL CLINICAL NEUROSCIENCE, INC.
Entity type:Organization
Organization Name:CAPITOL CLINICAL NEUROSCIENCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ELIAS
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-799-1801
Mailing Address - Street 1:104 SUMMER SHADE CT
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-1565
Mailing Address - Country:US
Mailing Address - Phone:916-799-1801
Mailing Address - Fax:916-988-9919
Practice Address - Street 1:5650 MARCONI AVE STE 6
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4467
Practice Address - Country:US
Practice Address - Phone:916-799-1801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-09
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty