Basic Information
Provider Information
NPI: 1003886029
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAPUTO
FirstName: ROY
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1007
Address2:  
City: MURRIETA
State: CA
PostalCode: 925641007
CountryCode: US
TelephoneNumber: 9517193330
FaxNumber: 9512966706
Practice Location
Address1: 8555 FLORENCE AVE
Address2:  
City: DOWNEY
State: CA
PostalCode: 902404014
CountryCode: US
TelephoneNumber: 5629239351
FaxNumber: 5626229041
Other Information
ProviderEnumerationDate: 01/23/2006
LastUpdateDate: 12/31/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0106XG57575CAY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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