Provider Demographics
NPI:1154528123
Name:COPELAND, GREGORY LEE (DO)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:LEE
Last Name:COPELAND
Suffix:
Gender:
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:255 W HERNDON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0381
Mailing Address - Country:US
Mailing Address - Phone:559-570-0070
Mailing Address - Fax:559-570-0059
Practice Address - Street 1:255 W HERNDON AVE STE 103
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-0381
Practice Address - Country:US
Practice Address - Phone:559-570-0070
Practice Address - Fax:559-570-0059
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2025-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A10829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine