Provider Demographics
NPI:1144237157
Name:KOPF, PAULA L (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:L
Last Name:KOPF
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:L
Other - Last Name:RUTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:8943 FENWICK ST
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1767
Mailing Address - Country:US
Mailing Address - Phone:818-352-1229
Mailing Address - Fax:
Practice Address - Street 1:14445 OLIVE VIEW DR
Practice Address - Street 2:OLIVE VIEW UCLA MEDICAL CENTER
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:818-364-4418
Practice Address - Fax:818-364-4538
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA423572/12196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily