Provider Demographics
NPI:1346211554
Name:CAPETANAKIS, ELENI I (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENI
Middle Name:I
Last Name:CAPETANAKIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3860 CALLE FORTUNADA
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:858-636-4300
Mailing Address - Fax:858-363-4319
Practice Address - Street 1:865 3RD AVENUE
Practice Address - Street 2:#101
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911
Practice Address - Country:US
Practice Address - Phone:619-426-7910
Practice Address - Fax:619-426-4953
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2011-02-02
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Provider Licenses
StateLicense IDTaxonomies
CAA70397208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA70397OtherMD LICENSE