Provider Demographics
NPI:1053508531
Name:WILLIAM J COPELAND MD INC
Entity Type:Organization
Organization Name:WILLIAM J COPELAND MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-945-4581
Mailing Address - Street 1:44215 15TH STREET WEST
Mailing Address - Street 2:STE 315
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4007
Mailing Address - Country:US
Mailing Address - Phone:661-945-4581
Mailing Address - Fax:661-949-5887
Practice Address - Street 1:44215 15TH STREET WEST
Practice Address - Street 2:STE 315
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4007
Practice Address - Country:US
Practice Address - Phone:661-945-4581
Practice Address - Fax:661-949-5887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41411207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G414110Medicaid
CA00G414110Medicaid
CAW21179Medicare PIN