Provider Demographics
NPI:1184835860
Name:CAPETANAKIS, NIKOLAS GEORGE (DO)
Entity Type:Individual
Prefix:
First Name:NIKOLAS
Middle Name:GEORGE
Last Name:CAPETANAKIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:535 ENCINITAS BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3742
Mailing Address - Country:US
Mailing Address - Phone:760-634-2814
Mailing Address - Fax:760-634-6785
Practice Address - Street 1:535 ENCINITAS BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3742
Practice Address - Country:US
Practice Address - Phone:760-634-2814
Practice Address - Fax:760-634-6785
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9622207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics