Basic Information
| Provider Information | |||||||||
| NPI: | 1548680564 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COPELAND MEDICAL INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 28946 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592285400 | ||||||||
| FaxNumber: | 5592241825 | ||||||||
| Practice Location | |||||||||
| Address1: | 7145 N CHESTNUT AVE STE 101 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937200359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592991178 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2014 | ||||||||
| LastUpdateDate: | 04/17/2014 | ||||||||
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| AuthorizedOfficialLastName: | COPELAND | ||||||||
| AuthorizedOfficialFirstName: | LEE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5592284311 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.