Provider Demographics
NPI:1336348648
Name:CAPDET, JORDI
Entity Type:Individual
Prefix:MR
First Name:JORDI
Middle Name:
Last Name:CAPDET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JORDI
Other - Middle Name:
Other - Last Name:CAPDET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:L AC
Mailing Address - Street 1:18128 CARL DR
Mailing Address - Street 2:
Mailing Address - City:JAMUL
Mailing Address - State:CA
Mailing Address - Zip Code:91935-2647
Mailing Address - Country:US
Mailing Address - Phone:619-220-0747
Mailing Address - Fax:
Practice Address - Street 1:3446 PARK BLVD
Practice Address - Street 2:204
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5209
Practice Address - Country:US
Practice Address - Phone:619-220-0747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA8189171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist