Individual
MR. GLYNN MICHAEL COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1401 GARCES HIGHWAY, DELANO, CA 93215
(661) 725-4800
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
NA1013
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA1013
BS OF CA
CA
01
—
P00149460
RAILROAD MEDICARE
CA
Enumeration date
05/22/2006
Last updated
11/09/2007
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