Provider Demographics
NPI:1437467685
Name:KAPO ENTERPRISES
Entity Type:Organization
Organization Name:KAPO ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPOUSHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-754-1367
Mailing Address - Street 1:2171 S EL CAMINO REAL
Mailing Address - Street 2:SUITE 210-1A
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6229
Mailing Address - Country:US
Mailing Address - Phone:760-754-1367
Mailing Address - Fax:
Practice Address - Street 1:2171 S EL CAMINO REAL
Practice Address - Street 2:SUITE 210-1A
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6229
Practice Address - Country:US
Practice Address - Phone:760-754-1367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty