Provider Demographics
NPI:1588835375
Name:CAPITOL ENDOCRINOLOGY INC
Entity Type:Organization
Organization Name:CAPITOL ENDOCRINOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAIWANT
Authorized Official - Middle Name:
Authorized Official - Last Name:RANGI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:530-677-0700
Mailing Address - Street 1:PO BOX 2890
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-2890
Mailing Address - Country:US
Mailing Address - Phone:530-677-0700
Mailing Address - Fax:530-676-3666
Practice Address - Street 1:1600 CREEKSIDE DR STE 2700
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3485
Practice Address - Country:US
Practice Address - Phone:530-677-0700
Practice Address - Fax:530-676-7850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2007 041220OtherBUSINESS LICENSE