Provider Demographics
NPI:1518361005
Name:LEO J. CAPOBIANCO, DO, LTD.
Entity Type:Organization
Organization Name:LEO J. CAPOBIANCO, DO, LTD.
Other - Org Name:DOCTORS CENTER HENDERSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPOBIANCO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-885-7790
Mailing Address - Street 1:2801 N TENAYA WAY STE C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1400
Mailing Address - Country:US
Mailing Address - Phone:702-684-7800
Mailing Address - Fax:702-684-7878
Practice Address - Street 1:1681 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3494
Practice Address - Country:US
Practice Address - Phone:702-998-5549
Practice Address - Fax:702-463-9268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV958207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty