Healthcare Provider Details

I. General information

NPI: 1245277664
Provider Name (Legal Business Name): LILIA FERNANDEZ COPPA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LILIA FERNANDEZ M.D.

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 W GONZALES RD STE 130
OXNARD CA
93036-0721
US

IV. Provider business mailing address

24422 AVENIDA DE LA CARLOTA STE 300
LAGUNA HILLS CA
92653-3628
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-7691
  • Fax: 805-981-7676
Mailing address:
  • Phone: 949-599-2423
  • Fax: 949-599-2430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG077445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: