Provider Demographics
NPI:1619059615
Name:CAPACITE, EDGARDO CABUNOC
Entity Type:Individual
Prefix:
First Name:EDGARDO
Middle Name:CABUNOC
Last Name:CAPACITE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMDT CG 1122 COAST GUARD
Mailing Address - Street 2:2100 2ND ST SW, SUTIE 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:707-839-6182
Mailing Address - Fax:707-839-6178
Practice Address - Street 1:COMDT CG 1122 COAST GUARD
Practice Address - Street 2:2100 2ND ST SW, SUTIE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:707-839-6182
Practice Address - Fax:707-839-6178
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other