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General NPI Number Information
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NPI Number | 1396828539
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Entity Type | Individual
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Provider Name | ELIZABETH COOPER R.D., PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 3300 WEBSTER ST STE 710
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City | OAKLAND
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State | CA
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Zip | 94609-3122
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Country | US
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Telephone | 510-465-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 3016 SANTA CLARA AVE
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City | ALAMEDA
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State | CA
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Zip | 94501-3138
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Country | US
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Telephone | 601-862-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 20830
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License Number State | CA
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