MEDICARE: ALFRED J COPPOLA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	G39988	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679578090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFRED J COPPOLA MD

Provider Business Mailing Address
First Line	:	PO BOX 2326
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93303-2326
Country	:	US
Telephone Number	:	661-324-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	9300 STOCKDALE HWY STE 300
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93311-3611
Country	:	US
Telephone Number	:	661-664-2200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	10/07/2025

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