Provider Demographics
NPI:1770737850
Name:CAPRAU, DIANA M (MD)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:M
Last Name:CAPRAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-7134
Mailing Address - Country:US
Mailing Address - Phone:909-809-9968
Mailing Address - Fax:
Practice Address - Street 1:1609 GARDEN ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-7134
Practice Address - Country:US
Practice Address - Phone:909-809-9968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-16
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1218592080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine