Provider Demographics
NPI:1477624609
Name:COOPER, ALLEN D (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:D
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:M211
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-725-9624
Mailing Address - Fax:650-723-5488
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:M211
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-725-9624
Practice Address - Fax:650-723-5488
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG16876207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA39936Medicare UPIN