Provider Demographics
NPI:1225214349
Name:ARTHUR KOPP M.D. AND MARINA BUSSEL M.D., INC
Entity Type:Organization
Organization Name:ARTHUR KOPP M.D. AND MARINA BUSSEL M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-721-9030
Mailing Address - Street 1:13031 VILLOSA PL APT 424
Mailing Address - Street 2:
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-6503
Mailing Address - Country:US
Mailing Address - Phone:310-721-9030
Mailing Address - Fax:310-751-6567
Practice Address - Street 1:13031 VILLOSA PL APT 424
Practice Address - Street 2:
Practice Address - City:PLAYA VISTA
Practice Address - State:CA
Practice Address - Zip Code:90094-6503
Practice Address - Country:US
Practice Address - Phone:310-721-9030
Practice Address - Fax:310-751-6567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA883712084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty