Individual
DANIEL J COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2505 W HAMMER LN, STOCKTON, CA 95209-2839
(209) 957-7050
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A6218
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX62180
—
CA
Enumeration date
09/13/2005
Last updated
03/17/2018
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