Provider Demographics
NPI:1720634173
Name:SCAPA, FRANK RUSSELL (PHARMD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:RUSSELL
Last Name:SCAPA
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 1:38 LEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-5539
Mailing Address - Country:US
Mailing Address - Phone:949-558-1819
Mailing Address - Fax:
Practice Address - Street 1:25511 MUIRLANDS BLVD
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4742
Practice Address - Country:US
Practice Address - Phone:949-454-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHA357771835P2201X, 183500000X
CA35777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA35777OtherCALIFORNIA BOARD OF PHARMACY