Individual
DR. JAY M. COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 CANAL ST, SUITE B, KING CITY, CA 93930-3431
(831) 385-1280
(831) 385-1285
Mailing address
PO BOX 667, KING CITY, CA 93930-0667
(831) 385-1280
(831) 385-1285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A69042
CA
208M00000X
Hospitalist Physician
Primary
A69042
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A690420
BLUE SHIELD PIN
CA
05
—
00A690420
—
CA
01
—
9416832
PHCS
—
Enumeration date
01/20/2006
Last updated
02/14/2011
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