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Individual
DR. JAY M. COOPER
Active
Individual
DR. JAY M. COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A69042
CA
208M00000X
Hospitalist Physician
Primary
A69042
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A690420
BLUE SHIELD PIN
CA
05
—
00A690420
—
CA
01
—
9416832
PHCS
—
Enumeration date
01/20/2006
Last updated
02/14/2011
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