Organization
KENNETH C. COOPER
Active
Other names
K C Medical
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH CHARLES COOPER (OWNER)
(310) 733-4433
Entity
Organization
Contact information
Practice address
3760 MOTOR AVE, SUITE 214, LOS ANGELES, CA 90034-6404
(310) 733-4433
(310) 733-4122
Mailing address
3760 MOTOR AVE, SUITE 214, LOS ANGELES, CA 90034-6404
(310) 733-4433
(310) 733-4122
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D02294F
—
CA
Enumeration date
11/08/2005
Last updated
10/15/2010
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