Individual
DR. ANTHONY SUSEELKANTH KOPPULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
757 WESTWOOD PLZ, 7501A, LOS ANGELES, CA 90095-8358
(310) 267-9630
Mailing address
757 WESTWOOD PLZ, 7501A, LOS ANGELES, CA 90095-8358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A100501
CA
207RC0000X
Cardiovascular Disease Physician
Primary
100501
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A1005010
—
CA
Enumeration date
06/26/2008
Last updated
08/11/2015
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