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General NPI Number Information
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NPI Number | 1780906404
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Entity Type | Individual
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Provider Name | EARL COOPER M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 2424 8TH AVE.
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City | LOS ANGELES
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State | CA
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Zip | 90018
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Country | US
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Telephone | 323-731-2510
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 3785
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City | BEVERLY HILLS
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State | CA
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Zip | 90212
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Country | US
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Telephone | 373-731-2510
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C22318
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License Number State | CA
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