Individual
JERRY DAVID COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
3451 E 12TH ST, OAKLAND, CA 94601-3463
(510) 535-4000
(510) 535-4128
Mailing address
1601 FRUITVALE AVE, OAKLAND, CA 94601-2418
(510) 535-4000
(510) 535-4128
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
CA
Other
Enumeration date
07/07/2010
Last updated
07/07/2010
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