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NPI Code Detail

MEDICARE: AMY KOPLOVSKY MD

MEDICARE: AMY KOPLOVSKY MD
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
1207P00000XEmergency Medicine PhysicianA55455CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578519963
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY KOPLOVSKY MD
Provider Business Mailing Address
First Line : PO BOX 2705-605
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92647
Country : US
Telephone Number : 562-809-3571
Fax Number :
Provider Business Practice Location Address
First Line : 3630 E IMPERIAL HWY
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-2609
Country : US
Telephone Number : 310-900-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 11/29/2021

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