Carmen C Capodanno, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

636220 Issued in CA

Practice address

1360 W 6TH St
Ste 270
San Pedro, CA 90732-3539

Phone

(310) 831-1272

Fax

(310) 831-1273

NPI assigned

Jun 8, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Csi Medical Group

  • MOHS-Micrographic Surgery Physician
  • San Pedro, CA
  • NPI 1871909804

  Dermatology

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821092859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST",
            "address_2": "STE 270",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323539",
            "telephone_number": "310-831-1272",
            "fax_number": "310-831-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST",
            "address_2": "STE 270",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323539",
            "telephone_number": "310-831-1272",
            "fax_number": "310-831-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPODANNO",
        "first_name": "CARMEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "636220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G362200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cancer Care Associates Medical Group Inc
• Christopher Santos Canlas, PT, DPT
• Consuelo Cantu
• Celina Caovan, PT, DPT
• Sharonda Capers
• Divina Capote
• Ma Karim Carbajal
• Candace Cargill-Fuller, CADC II
• Caring Angels Home Care LLC
• Carmen Capodann MD Inc

• Dermatology Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.