1427269588 NPI number — CAPITOL BUSINESS DEVELOPMENT INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427269588 NPI number — CAPITOL BUSINESS DEVELOPMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPITOL BUSINESS DEVELOPMENT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427269588
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5529 N CLEO AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93722-7713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-281-6882
Provider Business Mailing Address Fax Number:
818-804-4047

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6300 MORAGA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PIEDMONT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94611-2256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-281-6882
Provider Business Practice Location Address Fax Number:
818-804-4047
Provider Enumeration Date:
05/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCGUIRE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
909-821-8023

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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