Provider Demographics
NPI:1578849956
Name:CAPPARELLI, EDMUND VINCENT (PHARMD)
Entity Type:Individual
Prefix:
First Name:EDMUND
Middle Name:VINCENT
Last Name:CAPPARELLI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 600037
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92160-0037
Mailing Address - Country:US
Mailing Address - Phone:619-287-7091
Mailing Address - Fax:
Practice Address - Street 1:8085 HEMINGWAY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-1715
Practice Address - Country:US
Practice Address - Phone:619-287-7091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist