Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | G32523 | CA |
NPI | 1053324079 |
---|---|
Provider Name | Alex Koper |
First Address | Santa Barbara, CA 93160-2106 |
Second Address | Santa Barbara, CA 93110-1416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 10/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G325230 | (05) | CA |
A45181 | (02) | CA |