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General NPI Number Information
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NPI Number | 1417602186
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Entity Type | Individual
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Provider Name | NATHAN DAVID KOPP PHD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2022
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Last Update Date | 03/05/2022
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Provider Practice Location Address
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Address Line | 10833 LE CONTE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90095-3075
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Country | US
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Telephone | 310-948-2352
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 VETERAN AVE APT 247
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City | LOS ANGELES
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State | CA
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Zip | 90024-4844
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Country | US
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Telephone | 217-491-5677
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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 | 246ZG1000X
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Taxonomy Name | Medical Geneticist (PhD) Specialist/Technologist
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License Number |
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License Number State |
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