Provider Demographics
NPI:1225617228
Name:NAGAKI, COOPER ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:COOPER
Middle Name:ALLEN
Last Name:NAGAKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W. CARSON ST.
Mailing Address - Street 2:#461
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502
Mailing Address - Country:US
Mailing Address - Phone:424-306-8070
Mailing Address - Fax:310-553-1841
Practice Address - Street 1:1000 W CARSON ST
Practice Address - Street 2:#461
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502
Practice Address - Country:US
Practice Address - Phone:424-306-8070
Practice Address - Fax:310-553-1841
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program