Provider Demographics
NPI:1194379149
Name:KAPITZ, ADAM JOSEPH (PA)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:JOSEPH
Last Name:KAPITZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:A.J.
Other - Middle Name:
Other - Last Name:KAPITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:180 S LAKE AVE STE 615
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4763
Mailing Address - Country:US
Mailing Address - Phone:866-536-5918
Mailing Address - Fax:310-777-2702
Practice Address - Street 1:180 S LAKE AVE STE 615
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4763
Practice Address - Country:US
Practice Address - Phone:866-536-5918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant