Provider Demographics
NPI:1033119946
Name:CAPPARELLI, ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:CAPPARELLI
Suffix:
Gender:M
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:PO BOX 2160
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93020-2160
Mailing Address - Country:US
Mailing Address - Phone:818-718-2301
Mailing Address - Fax:818-718-2311
Practice Address - Street 1:375 ROLLING OAKS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1023
Practice Address - Country:US
Practice Address - Phone:805-497-7775
Practice Address - Fax:805-557-1074
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51479207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF12743Medicare UPIN
CAWG51479BMedicare ID - Type UnspecifiedMEDICARE PPIN NUMBER