Provider Demographics
NPI:1992086391
Name:STEPHEN COPEN MD INC
Entity type:Organization
Organization Name:STEPHEN COPEN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:COPEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-232-6131
Mailing Address - Street 1:905 NAPOLI DR
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-4037
Mailing Address - Country:US
Mailing Address - Phone:323-232-6131
Mailing Address - Fax:323-232-1501
Practice Address - Street 1:874 W MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-1205
Practice Address - Country:US
Practice Address - Phone:323-232-6161
Practice Address - Fax:323-232-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty