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NPI Code Detail

MEDICARE: ANTONIO ALBERTO DIAZ COOPER NP

MEDICARE:   ANTONIO ALBERTO DIAZ COOPER  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner95034612CA

General Provider Information

NPI Number : 1184418204
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTONIO ALBERTO DIAZ COOPER NP
Provider Business Mailing Address
First Line : 5743 CORSA AVE STE 112
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91362-6441
Country : US
Telephone Number : 805-790-5300
Fax Number :
Provider Business Practice Location Address
First Line : 5743 CORSA AVE STE 112
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91362-6441
Country : US
Telephone Number : 805-790-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2025
Last Update Date : 06/04/2026

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Directions to “ ANTONIO ALBERTO DIAZ COOPER NP” Practice Location

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