Provider Demographics
NPI:1699356626
Name:CAPISTRANO, DAVID JOHN (RN)
Entity Type:Individual
Prefix:
First Name:DAVID JOHN
Middle Name:
Last Name:CAPISTRANO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 MELISSA CIR
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-2138
Mailing Address - Country:US
Mailing Address - Phone:650-270-6090
Mailing Address - Fax:
Practice Address - Street 1:191 MELISSA CIR
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-2138
Practice Address - Country:US
Practice Address - Phone:650-270-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95190251163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse