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General NPI Number Information
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NPI Number | 1457738528
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Entity Type | Individual
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Provider Name | JONATHAN COPP
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Gender | Male
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 4860 Y ST STE 3800
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City | SACRAMENTO
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State | CA
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Zip | 95817-2307
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Country | US
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Telephone | 916-734-2807
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 505673
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City | SAINT LOUIS
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State | MO
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Zip | 63150-5673
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Country | US
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Telephone |
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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 | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | 2024037223
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | A168796
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License Number State | CA
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