Organization
JAY COOPER MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY M. COOPER MD (PRESIDENT)
(831) 385-7263
Entity
Organization
Contact information
Practice address
300 CANAL ST, SUITE B, KING CITY, CA 93930-3431
(831) 385-7263
(805) 385-7133
Mailing address
PO BOX 667, KING CITY, CA 93930-0667
(805) 385-1280
(805) 385-1285
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
2741659
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ50259Y
BLUE SHIELD PIN
CA
Enumeration date
03/20/2007
Last updated
05/07/2010
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