Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A23523 | CA |
NPI | 1528154689 |
---|---|
Provider Name | Dr. Stephen Hart Cooper |
First Address | Tarzana, CA 91356 |
Second Address | Tarzana, CA 91356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A23523 | (05) | CA |
A23579 | (02) |