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General NPI Number Information
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NPI Number | 1093059362
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Entity Type | Organization
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Legal Business Name | RONALD E. COOPER, M.D., INC.
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 1081 MARKET PL STE 600
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City | SAN RAMON
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State | CA
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Zip | 94583-4749
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Country | US
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Telephone | 925-830-0852
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Fax | 925-830-0854
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Provider Business Mailing Address
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Address Line | 1081 MARKET PL STE 600
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City | SAN RAMON
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State | CA
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Zip | 94583-4749
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Country | US
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Telephone | 925-830-0852
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Fax | 925-830-0854
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD E COOPER
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Credential | M.D.
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Telephone | 925-830-0852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G62441
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License Number State | CA
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