Individual
COOPER A BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
2946 E BANNER GATEWAY DR, GILBERT, AZ 85234-2165
(480) 256-6444
Mailing address
2946 E BANNER GATEWAY DR, GILBERT, AZ 85234-2165
(480) 256-6444
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/11/2025
Last updated
04/09/2026
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