Individual
KATHY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(619) 528-5000
Mailing address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A13823
CA
207P00000X
Emergency Medicine Physician
238647
NY
207P00000X
Emergency Medicine Physician
Q1380
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02812164
—
NY
Enumeration date
08/24/2006
Last updated
12/22/2021
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