Healthcare Provider Details

I. General information

NPI: 1962315432
Provider Name (Legal Business Name): HOMEDOC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2584 RESERVE ST
ERIE CO
80516-2505
US

IV. Provider business mailing address

PO BOX 479
ERIE CO
80516-0479
US

V. Phone/Fax

Practice location:
  • Phone: 720-607-9207
  • Fax:
Mailing address:
  • Phone: 720-607-9207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YOESMI KOPEL
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 909-225-8048