Individual
MS. ELISABETH COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1035 PLACER ST, REDDING, CA 96001-1125
(530) 246-5710
(530) 229-1206
Mailing address
PO BOX 992790, REDDING, CA 96099-2790
(530) 246-5710
(530) 229-1206
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085-002670
IL
363A00000X
Physician Assistant
Primary
PA22308
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085-002670
—
IL
Enumeration date
06/12/2006
Last updated
09/10/2012
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