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Individual

ELLEN MICHELE COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10051 LAKE AVE STE 4, TRUCKEE, CA 96161-4870
(530) 587-7698
Mailing address
10051 LAKE AVE STE 4, TRUCKEE, CA 96161-4870
(530) 587-7698

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A116674
CA
208600000X
Surgery Physician
ML20008204
WA

Other

Enumeration date
08/19/2006
Last updated
02/16/2012
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