Provider Demographics
NPI:1578789194
Name:COPELAN, NATHAN BRYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:BRYAN
Last Name:COPELAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3156 VISTA WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-3622
Mailing Address - Country:US
Mailing Address - Phone:760-940-4055
Mailing Address - Fax:760-940-4084
Practice Address - Street 1:3156 VISTA WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-3622
Practice Address - Country:US
Practice Address - Phone:760-940-4055
Practice Address - Fax:760-940-4084
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2021-11-30
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Provider Licenses
StateLicense IDTaxonomies
CAA932682085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology