Individual
DR. GARY P. COPPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
147 N BRENT ST, VENTURA, CA 93003-2809
(805) 652-5011
Mailing address
3116 W MARCH LN, #200, STOCKTON, CA 95219-2369
(209) 473-6555
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G79833
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G798330
—
CA
Enumeration date
07/19/2006
Last updated
12/22/2015
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