Provider Demographics
NPI:1164827887
Name:ROY J. CAPUTO, M.D., INC.
Entity Type:Organization
Organization Name:ROY J. CAPUTO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAPUTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-403-2483
Mailing Address - Street 1:PO BOX 1310
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92781-1310
Mailing Address - Country:US
Mailing Address - Phone:714-403-2483
Mailing Address - Fax:951-260-0107
Practice Address - Street 1:1400 S HARBOR BLVD
Practice Address - Street 2:STE A
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-7577
Practice Address - Country:US
Practice Address - Phone:714-879-3400
Practice Address - Fax:714-441-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57575207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty