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General NPI Number Information
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NPI Number | 1912982851
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Entity Type | Individual
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Provider Name | EDWARD CECIL COOPER MD
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3161 WALNUT AVE
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City | FREMONT
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State | CA
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Zip | 94538-2216
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Country | US
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Telephone | 510-796-1000
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Fax | 510-796-1050
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Provider Business Mailing Address
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Address Line | PO BOX 1129
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City | DANVILLE
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State | CA
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Zip | 94526-8129
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G32478
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License Number State | CA
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