=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013384882
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABBY COOPER LAC DIPL OM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2015
-----------------------------------------------------
Last Update Date | 04/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2424 TORRANCE BLVD STE B
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501-2453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-586-0459
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2846 EL DORADO ST
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90503-6038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-586-0459
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 00001985
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------