MEDICARE: RONNELLE ANANI COPES

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
1	390200000X	Student in an Organized Health Care Education/Training Program	INT46571	CA

General Provider Information

NPI Number	:	1356952915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONNELLE ANANI COPES

Provider Business Mailing Address
First Line	:	2215 ALCAZAR ST APT 402
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1003
Country	:	US
Telephone Number	:	720-975-6425
Fax Number	:

Provider Business Practice Location Address
First Line	:	2215 ALCAZAR ST APT 402
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1003
Country	:	US
Telephone Number	:	720-975-6425
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2020
Last Update Date	:	08/16/2020

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Directions to “ RONNELLE ANANI COPES ” Practice Location

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