Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | G10375 | CA |
NPI | 1063475135 |
---|---|
Provider Name | Joel D. Kopple |
First Address | Torrance, CA 90502-2047 |
Second Address | Torrance, CA 90502-2047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G103750 | (05) | CA |
A37947 | (02) | CA |