Basic Information
| Provider Information | |||||||||
| NPI: | 1326134560 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COOPERMAN | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14445 OLIVE VIEW DR | ||||||||
| Address2: | OLIVE VIEW-UCLA MED CTR, NORTH ANNEX | ||||||||
| City: | SYLMAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913421437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8183643632 | ||||||||
| FaxNumber: | 8183643244 | ||||||||
| Practice Location | |||||||||
| Address1: | 14445 OLIVE VIEW DR | ||||||||
| Address2: | OLIVE VIEW-UCLA MED CTR, NORTH ANNEX | ||||||||
| City: | SYLMAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913421437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8183643632 | ||||||||
| FaxNumber: | 8183643244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | G75754 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.