MEDICARE: DR. KAREN KOPIKO O.D., F.A.A.O.

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	152W00000X	Optometrist	11256T	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1629005939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN KOPIKO O.D., F.A.A.O.

Provider Business Mailing Address
First Line	:	671 PARKER AVE
Second Line	:
City	:	RODEO
State	:	CA
Zip	:	94572-1434
Country	:	US
Telephone Number	:	510-799-4258
Fax Number	:	510-799-6616

Provider Business Practice Location Address
First Line	:	671 PARKER AVE
Second Line	:
City	:	RODEO
State	:	CA
Zip	:	94572-1434
Country	:	US
Telephone Number	:	510-799-4258
Fax Number	:	510-799-6616

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	03/07/2023

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